1. Blue Button Plus Push Workgroup Meeting April 22, 2013

2. Meeting Etiquette Remember: If you are not speaking, please keep your phone on mute Do not put your phone on hold. If you need to take a call, hang up and dial in again when finished with your other call o Hold = Elevator Music = frustrated speakers and participants This meeting is being recorded o Another reason to keep your phone on mute when not speaking Use the “Chat” feature for questions, comments and items you would like the moderator or other participants to know. o Send comments to All Panelists so they can be addressed publically in the chat, or discussed in the meeting (as appropriate). From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute All Panelists 2

3. Agenda TopicTime Allotted Announcements, Meeting & Event Reminders Direct Connect-a-thon (May 9) Health Datapallooza IV (June 2) 5 minutes Directory Workflow Update (Josh M.) Triggers & Automation Update (Virinder B.) Review Updates to the IG Next Steps5 minutes 3

4. Announcements and Reminders 4 Meeting Reminders – Push Workgroup has moved to a bi-weekly schedule. – Next Push Workgroup Meeting is scheduled for Monday, May 6, 2013 @ 2:00 pm Eastern. – Meeting information is on the Blue Button Plus Wiki Page: http://wiki.siframework.org/Automate+Blue+Button+Initiative http://wiki.siframework.org/Automate+Blue+Button+Initiative

5. Direct Connect a Thon – May 9, 2013 Thursday, May 9, 2013 @ 11:00 am Eastern 20-30 minute presentation slots available – Contact Greg Meyer (GMEYER@cerner.com)GMEYER@cerner.com Register – http://wiki.directproject.org/May+2013+Connect-A-Thon http://wiki.directproject.org/May+2013+Connect-A-Thon

6. Dates: June 3 – 4, 2013 Location: Omni Shoreham Hotel (Washington, DC) Health Datapalooza IV (HDP IV) is the fourth annual national conference born from government efforts to liberate health data. The conference is a forum that features the newest and most innovative and effective uses of health data by companies, startups, academics, government agencies and individuals. Sessions of Interest – “Powering Applications Using Consumer Data: Blue Button + For Developers. “ – “Unlocking Clinical & Claims Data by Giving Consumers Access: Blue Button + For Data Holders” Be a part of it (Deadline April 5) – http://healthdatapalooza.org/present http://healthdatapalooza.org/ – Panel spots are also open (dataholders & developers) Registration ends May 24. – $750 Standard – $495 Govt/Academic/Non-profit More information here: http://healthdatapalooza.org/http://healthdatapalooza.org/ Register here: http://healthdatapalooza.eventbrite.com/http://healthdatapalooza.eventbrite.com/

7. Follow Up from April 8 th meeting Directory Workflow – Update – Request for Comments & Feedback – http://blue-button.github.io/blue-button-plus-pull http://blue-button.github.io/blue-button-plus-pull Triggers and Automation – Virinder B. completed redline edits to the IG text – Review and discuss with community – http://wiki.siframework.org/file/view/BBPlus_Transmit _w_Direct_2013_04_12_VB.docx http://wiki.siframework.org/file/view/BBPlus_Transmit _w_Direct_2013_04_12_VB.docx

8. Discussion on Authorization Workflow (from April 22) See issue tracker in github: Instead of calling them ‘trust bundles’, recommend using ‘blue button plus registries’ Propose linking to this work from the BB+ IG; even considering rolling it in as a new section to the BB+ Guide. – Required or optional? Optional – Any objections? None at this time

9. Discussion on Authorization Workflow (cont’d) (from April 22) Q: How does this fit into other Directories? A: Directory structure is built in (e.g. list of apps and list of providers) to facilitate OAuth2. Directory system that we are proposing is not directly DNS based, not like a certificate repository, or LDAP. It is more of a web-protocol for service discovery. It is fundamentally different from other directory architectures out there. Comment (Adrian): The only other directory like this is the Mass HIE, where we invented a protocol for populating that directory. ACTION: Adrian will send an email (as BB+) with the information request about the Mass HIE protocol and Adrian will forward that request. Their system might solve a similar problem and would be good to see what they have. Comment (Less): California / Kaiser may have also developed something similar.

10. Discussion on Triggers & Automation (from April 22) Next Steps – Community to review changes made during today’s discussion. – http://wiki.siframework.org/file/view/BBPlus_Transmit_w _Direct_2013_04_12_VB_v2.docx http://wiki.siframework.org/file/view/BBPlus_Transmit_w _Direct_2013_04_12_VB_v2.docx – For May 6: Continue discussion focusing on Payload.

11. Homework, Events and Meeting Reminders 11 Homework – Review & Comment on changes made to IG re: Triggers and Automation during today’s discussion. http://wiki.siframework.org/file/view/BBPlus_Transmit_w_Direct_2013_04_12_ VB_v2.docx http://wiki.siframework.org/file/view/BBPlus_Transmit_w_Direct_2013_04_12_ VB_v2.docx Prepare to give payload examples when discussion continues on May 6, 2013. – Review & Comment on Authorization Workflow http://blue-button.github.io/blue-button-plus-pull Opportunities to Connect – Direct Connect-a-Thon: May 9, 2013 @ 11:00 am Eastern http://wiki.directproject.org/May+2013+Connect-A-Thon – Health Datapalooza: June 2 – 3, 2013 http://healthdatapalooza.org/ Meeting Reminders – Next PUSH Workgroup Meeting is Monday, May 6, 2013 @ 2:00 pm Eastern. – http://wiki.siframework.org/Automate+Blue+Button+Initiative http://wiki.siframework.org/Automate+Blue+Button+Initiative

12. Contact Information 12 For questions, please contact your support leads – Initiative Coordinator: Pierce Graham-Jones (pierce.graham-jones@hhs.gov)pierce.graham-jones@hhs.gov – Project Manager: Jennifer Brush (jennifer.brush@esacinc.com)jennifer.brush@esacinc.com – S&I Admin: Apurva Dharia (apurva.dharia@esacinc.com)apurva.dharia@esacinc.com

13. Next Steps for Blue Button+ Pull WG Adoption – Focus on data holder adoption (vendors, providers, & payors) – Focus on developers of 3 rd Party applications that would like to design based on the BB+ IG – ACTION: Identify opportunities for us to get vendors / providers / payors on board with BB+ Dedicated Destination on BlueButtonPlus.Org for Tool Kit items – Consolidated CDA Score Card *!* – NIST Testing Tools – Style Guide Libraries (from Design Challenge) – Button / Icon design options (standards) – Receivers: note any patterns in the data / setup that are negative / incorrect, please let us know so that we can help identify those now IG Expansion – Facilitate usability and not require a user to have their Direct address – Flesh out the specifics of the Directory Service (based on Josh M’s work).

14. Appendix Previous Meeting Slides

15. Follow Ups Directory Workflow – Josh & Justin to meet; identify and document concerns, working to understand the gap between the workflow and existing protocols. – Present to the community during April 8 meeting. Triggers and Automation – Virinder B. to outline sections for adding to the IG. – Present to the Push Workgroup on April 8. – http://wiki.siframework.org/file/view/BlueButtonAutomation201 30408.pdf/421118224/BlueButtonAutomation20130408.pdf http://wiki.siframework.org/file/view/BlueButtonAutomation201 30408.pdf/421118224/BlueButtonAutomation20130408.pdf

16. Discussion on Directory Workflow (from April 8) Github URL: http://blue-button.github.io/blue-button-plus-pull http://blue-button.github.io/blue-button-plus-pull Josh & Justin presented the overall workflow and concept. Goal is to build a better facing patient workflow. Dataholder Summary: Every data holder is responsible for registering apps. That can happen in an open way, or in a trusted way (preferred). In the latter case, the idea is that the trust bundle which is trusted by the provider already contains information about this app, and is used to verify the application’s request. Next Steps – Pierce will coordinate offline discussion with Josh / Justin re: how to move forward and identify and adopter. – Discussion will continue during the next Push WG call on April 22, 2013.

17. Discussion on Triggers & Automation (from April 8) Moving forward (option): Give the five examples as options; let the vendor’s implement the ones they want; use their Reference Implementations to tell us which ones work vs. not. Eventually make some of them mandatory and some optional. Next Steps – Virinder will red-line/edit the triggers & automation section, and the payload section. Ryan and Pierce will work with him to help / add it to the website. – Continue this discussion in the next (April 22) call based on the updated sections of the IG (http://bluebuttonplus.org).http://bluebuttonplus.org