1. Automate Blue Button Initiative Push Workgroup Meeting November 19, 2012

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 Welcome and Announcements5 minutes Timeline, Status, Deliverables, Dashboard5 minutes Review Draft Implementation Guides45 minutes Next Steps / Reminders5 minutes 3

4. Announcements and Reminders 4 Meeting Reminders – Push Workgroup Meetings are Mondays from 2:00 – 3:00 pm Eastern. – The next Community Meeting will be held as needed. – Direct Connect-a-Thon (December 6, 2012) – ABBI Face to Face (December 11, 2012 from 2:30-4 pm) – Meeting information is on the Automate Blue Button Wiki Page: http://wiki.siframework.org/Automate+Blue+Button+Initiative http://wiki.siframework.org/Automate+Blue+Button+Initiative Community Homework – Provide comments and feedback on the Push Implementation Guides: http://wiki.siframework.org/Push+Implementation+Guidance+Comments+and+ Feedback

5. Looking Forward ABBI Schedule November – October 22- November 19: Drafting and comment period on ABBI Implementation Guide (Part 1: Send via Direct + Content) – Nov 19 th : BEGIN Comment Period Round 2 on ABBI Implementation Guide (Part 1: Send via Direct, Content) – 26 th : Discuss Comments in workgroup calls – 28 th : END Comment Period on ABBI IG (Part 1) December – 3 rd : Review Implementation Guide Comments in Workgroup Calls and Finalize Guide – 6 th : ABBI Participates in Connect-a-thon – 10 th : “Public Release” of ABBI Implementation Guide (Part 1) – 11 th : ABBI Participates in Town Hall @ ONC Annual Meeting – 21 st : BEGIN Comment Period on ABBI Implementation Guide (Part 2: Send via Email, Payer Content, and Developer Toolkit) January – ~ 10 th : END Comment Period on ABBI Implementation Guide (Part 2) – ~ 15 th : Release ABBI Implementation Guide (Part 2) – All of January: Testing Period; Identify and Respond to Reference Implementations February – Testing Period; Identify and Respond to Reference Implementations March – Complete Testing Period – HIMSS: Showcase ABBI Implementations – Release Final Automate Blue Button v2 Implementation Guide (Part 1 and Part 2 listed above)

6. Pre- Discovery Discovery Reference Implementations  Agreed and voted on charter, including  Scope  Timeline  Deliverables  Identified priority implementation options:  Transmit requirement of MU Stage 2 (from V/D/T requirement) + automation  Email + file encryption also discussed as option for PUSH  Wrote draft use case for two V/D/T + automation  Write draft use case for Email (and/or Payer) option  Identified issues related to V/D/T + automation  Write policy FAQ document to support PUSH options  Write draft implementation guide for V/D/T + automation  Write draft implementation guide for Email  Identify 1-2 V/D/T implementations that can serve as reference implementations for our group  Identify 1-2 vendors / data holders willing to work on Automated Push reference implementations Implementation Guidance Implementations  Refine use cases based on reference implementations  Refine implementation guide based on reference implementations  3-6 full implementations that reflect implementation guidance PUSH Current Status 6

7. WG Launch (09/17) Nov-12 Discovery S&I Framework Lifecycle Sep-12Mar-13 Pilot & Implementation Guidance Implementation Oct-12 Dec-12 Jan-13Feb-13 Finalize Implementation Guidance for Direct Use Case 1 Definition (DIRECT @ Physician’s Office) Use Case 2 Definition (DIRECT via Patient Portal) Use Case 3 Definition (Email) UC3 Implementation Guidance for Email Full implementations with providers / Payers Timeline Outstanding Issues Pilots Identified & On Track Next StepsStatus PUSH Dashboard Draft Implemen tation Guidance Reference Implementations using Direct Reference Implementations using Email Push Workgroup 7  Write policy FAQ document to support PUSH options  Write draft implementation guide for V/D/T + automation  Write draft implementation guide for Email  Identify V/D/T implementations that can serve as reference implementations for our group  Identify vendors / dataholders willing to work on Automated Push reference implementations

8. PUSH Current Deliverables Implementation Guide Push Workgroup 8 http://wiki.siframework.org/file/view/ABBI+ IG+- +Transmitting+Data+Using+the+Direct+Prot ocol+2012-11-15.docx http://wiki.siframework.org/file/view/ABBI+ IG+- +Receiving+Health+Data+Using+the+Direct+ Protocol+2012-11-15.docx

9. Outstanding Questions Publically Discovered Certificates - DEFER How can we ensure patients will be able to send to “any” address? How can we ensure a minimal level of trust?

10. Flow 1: Patient Portal 1. Patient logs into portal

11. Flow 1: Patient Portal 2. Patient clicks on “Share with Direct”

12. Flow 1: Patient Portal 3. Patient reads and accepts transmit terms

13. Flow 1: Patient Portal 4. Patient enters Direct address and selects transmit frequency

14. Flow 1: Patient Portal 5. Flow Complete

15. Flow 1: Patient Portal 1. Patient logs into portal2. Patient clicks on “Share with Direct” 3. Patient reads and accepts transmit terms 4. Patient enters Direct address and selects transmit frequency

16. Flow 2: Provider

20. Next Steps / Reminders 20 Next Steps – Provide Feedback to revised Implementation Guide – Focus on Workflow Meeting Reminders – Next PUSH Workgroup Meeting is Monday, November 26 th, 2012 @ 2:00 pm Eastern. – The next Community Meeting will be held as needed. – http://wiki.siframework.org/Automate+Blue+Button+Initiative http://wiki.siframework.org/Automate+Blue+Button+Initiative Upcoming Face-to-Face Opportunities: – Dec 6 th – Direct Connect-a-thon which will include an ABBI opportunity – Dec 11th – ONC Annual Meeting – ABBI Town Hall For questions, please contact your support leads – Initiative Coordinator: Pierce Graham-Jones (pierce.graham-jones@hhs.gov)pierce.graham-jones@hhs.gov – Presidential Innovation Fellow: Ryan Panchadsaram (ryan.panchadsaram@hhs.gov)ryan.panchadsaram@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