1. NHIN Direct Implementation Group Meeting April 6, 2010

2. Agenda » Quick Summary of Last Meeting & Reminders » Updates Workgroups » User Story Review » Content Packaging » Security & Trust » Robust HIE Interoperability » Individual Involvement » Addressing » Abstract Model » Calendar & Participation » Next Steps

3. Reminders & Quick Summary of Last Meeting

4. Q&A Text Box Function »Use the Q&A text box function in the web conference to ask a question, or to signal an intent to speak »To type a question, please type questions into the Q&A text box and click »To vocalize a question, please use the “raise your hand” function found in the upper right hand corner:

5. Recap of Last Meeting »Abstract Model Workgroup Reviewed output of the working group, set expectations that we were close to calling for consensus »Addressing Workgroup Noted that group had level set and discussed framing for future meetings »Other Workgroups Reviewed meeting schedule »Other Discussion Better described purpose of Abstract Model, mappings to concrete implementations, issues related to perception of NHIN Direct vs. NHIN vs. CONNECT vs…

6. Timeline Review MarAprMayJunJulAugSepOct… Launch, internal kickoff, recruiting Start external meetings First Draft Specs 2 nd Draft Specs Early reference implementation Ref implementation and testing framework available Ops/prod draft cert. and conformance testing Weekly teleconferences Face to face meetings as indicated by We Are Here TBD 7/27 6/11 5/6

7. Deliverable Review Recommendations on Federal role, states, etc... Policy recommendations for trust enablement Formalized models (NIEM, service orchestration) Core specifications and service descriptions Conformance testing scripts and conformance service Reference implementation guides for edge systems and routing systems (including sample code, testing and conformance documentation, legal and policy documentation, etc...) Implementation guide for CONNECT users Core messaging Placements in industry journals, key social media outlets, etc... Use of NHIN Direct as a model (positive or negative) NIEM, modeling process recommendations Specifications & service descriptions includingPolicy recommendations Process recommendationsMarketing/awareness

8. Review of Workgroups »User Story Review Workgroup: Provide consistent, vetted set of user stories available on the Wiki »Content Packaging Workgroup: Define a few workable alternatives, with pros/cons, for content packaging »Security and Trust: Provide alternatives and highlight issues relating to security and trust enablement via technology (e.g., certificates and signatures) »Robust HIE Interoperability Workgroup: Define how to mix and match direct transactions and robust HIE/NHIN specifications and services (patient discovery and information access) capabilities at scale »Individual Involvement Workgroup: Clarify technology issues and policy implications for individual involvement in direct transport »Addressing Workgroup: Define an implementation neutral mechanism for addressing that enables provider/individual identification and enabling organization routing »Abstract Model Review Workgroup: Review and finalize a formal abstract model that all workgroups can use to define common vocabulary

9. Updates from the User Story Workgroup

10. Review of First Two Meetings »Reviewed key stories, defined story style guide, fit all Must stories to story guide, and proposed Must/Should cut points. »Peter DeVault is the workgroup lead »All output from group reflected in updated user stories and revised user story template http://nhindirect.org/User+Stories http://nhindirect.org/space.template.User+Story »More background in meeting notes http://nhindirect.org/User+Story+Meeting+2010-04-01 http://nhindirect.org/User+Story+Meeting+2010-04-05

11. Updates from the Content Packaging Workgroup

12. Review of First Meeting »Reviewed goals and objectives, discussed framing issues »David McCallie is the workgroup lead »Framing topics documented in notes for next meeting http://nhindirect.org/Content+Packaging+Meeting+2010-04-07 »More background in meeting notes http://nhindirect.org/Content+Packaging+Meeting+2010-03-31

13. Updates from the Security and Trust Workgroup

14. Review of First Meeting »Reviewed goals and objectives, discussed framing issues Renamed group to Security and Trust Defined Security and Trust policy assumption that we can assume pre-existing policy decision by data holder and transaction initiator that it is appropriate and legal to transmit data Will re-frame key issues for next meeting »Jonathan Gershater is the workgroup lead »More background in meeting notes http://nhindirect.org/Security+and+Trust+Meeting+2010-04-01

15. Updates from the Robust HIE Interop Workgroup

16. Review of First Meeting »Reviewed goals and objectives, discussed framing issues Will re-frame key issues for next meeting »No workgroup lead yet appointed »More background in meeting notes http://nhindirect.org/Robust+HIE+Meeting+2010-04-01

17. Updates from the Individual Involvement Workgroup

18. Review of First Meeting »Reviewed goals and objectives, discussed framing issues Framing issues for next meeting noted at http://nhindirect.org/Individual+Involvement+Meeting+2010-04-08 http://nhindirect.org/Individual+Involvement+Meeting+2010-04-08 »Richard Elmore is workgroup lead »More background in meeting notes http://nhindirect.org/Robust+HIE+Meeting+2010-04-01

19. Updates from the Addressing Workgroup

20. Review of Second Meeting »Discussed a concrete proposal for an addressing specification Formalized at http://nhindirect.org/Addressing+Specificationhttp://nhindirect.org/Addressing+Specification Expectation of ability to move to call for consensus at next meeting »Wes Rishel is workgroup lead »More background in meeting note http://nhindirect.org/Addressing+Meeting+2010-03-31

21. Updates from the Abstract Model Review Workgroup

22. Agenda » Action Items » Next Steps and Backlog

23. Action Items – First an Overview »Abstract Model’s goal is to provide an implementation-agnostic expression of the transactions between actors implied by user stories »In other words, a common frame of reference and terminology on which concrete implementation ideas may be mapped Makes no implication about one versus many mappings »Currently modeled as three “legs” Source to HSP HSP to HSP HSP to Destination »Does not make any assumptions about how the responsibilities are deployed (i.e., an HSP is not, by definition, a separate org from a Source, but it could be) »See http://nhindirect.org/NHIN+Direct+Abstract+Modelhttp://nhindirect.org/NHIN+Direct+Abstract+Model

24. Action Items Message Status SupportOwnerStatus/Due Date Add Transaction 1.3 to fully support the concept of message status ArienCompleted 3/31 Language CleanupOwnerStatus/Due Date Clarify language for consistency and accuracy Arien et alCompleted 4/5

25. Next Steps Finalize Abstract Model Language & Get Workgroup Consensus OwnerStatus/Due Date Review any final concerns from the Workgroup on 4/7/2010 call and obtain final consensus. Arien/Brett4/7/2010 Bring to Implementation Group for Consensus OwnerStatus/Due Date Present to Implementation Group on 4/13/2010. Implementation Group members: Please take the time to read the abstract model before 4/13/2010. Brett/Arien4/13/2010

26. Comment and Contact Information »If further refinements to the Abstract Model are necessary based on input from other workgroups, such refinements will be discussed and brought to the Implementation Group. »To comment further on this topic please visit http://nhindirect.org/Abstract+Model+Workgroup http://nhindirect.org/Abstract+Model+Workgroup

27. Calendar & Participation

28. Workgroup Schedule »Workgroups adhere to the below schedule, meeting via teleconference on a weekly basis WorkgroupMeeting Time User Story Review Workgroup Mondays 11am-12pm EST Content Packaging Workgroup Wednesdays 1pm-2pm EST PKI/Certificates Workgroup Thursdays 2pm-3pm EST Robust HIE Interoperability Workgroup Tuesdays 2pm-3pm EST Individual Involvement Workgroup Thursdays 1pm-2pm EST Addressing Workgroup Wednesdays 3:30pm-4:30pm EST Abstract Model Review Workgroup Wednesdays 11am-12pm EST

29. Over 130 Implementation Group Participants »PHR Google Microsoft (HV/Amalga) »EHR Allscripts Cerner eClinicalWorks Epic GE NextGen McKesson (through RelayHealth) Oracle Health Sciences »HIE Technology RelayHealth (also PHR) Axolotl Mirth VisionShare GE MedAllies CSC Medicity Kryptiq MobileMD IBM/Open Health Tools »HIT Association Clinical Groupware Collaborative »Medical Associations American Academy of Family Physicians »State/Regional HIO CA (Jonah and David Lansky) CA (Redwood MedNet) TN (CareSpark) MA (NEHEN-CSC) MAeHC NY (HIXNY) NY (Hudson Valley) (through MedAllies) HITOC (Oregon Health Information Technology Oversight Council) RIQI (Rhode Island Quality Institute) Carespark »IDN Kaiser BIDMC/CareGroup »Consulting Manatt Gartner CGI Federal »National Network SureScripts Medplus/Quest »Federal VA SSA NIH NCI CMS NIST

30. Next Steps