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Interoperability for the NHIN

Interoperability for the NHIN. Thomas Jepsen, IEEE-USA MTPC. Version 1.3 Updated July 5, 2005. What is Interoperability?. “Ability of two or more systems or components to exchange information and to use the information that has been exchanged.” . Source: IEEE Standard Computer Dictionary:

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Interoperability for the NHIN

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  1. Interoperability for the NHIN Thomas Jepsen, IEEE-USA MTPC Version 1.3 Updated July 5, 2005

  2. What is Interoperability? “Ability of two or more systems or components to exchange information and to use the information that has been exchanged.” Source: IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990

  3. “Functional” vs. “Semantic” Interoperability • Functional Interoperability: • Shared Architectures • Shared Methods • Shared Frameworks • Semantic Interoperability: • Shared Datatypes • Shared Terminologies • Shared Codings Source: IEEE 1073/ISO TC215 WG2.1/CEN TC251 WGIV Point of Care Medical Device Communications

  4. A Real World Model: The Internet/World Wide Web • Functional interoperability – browsing/searching/online purchasing work the same, regardless of what browser I use or what operating system my computer uses • Semantic interoperability – the functional interoperability of the Internet/WWW relies on the semantic interoperability provided by http, html, xml, etc…

  5. What is NHIN? • National Health Information Network • Not a “physical” network, but rather a “conceptual” network • May include information that is not in electronic online format – e.g. legacy paper records • May consist of multiple networks with linkages to each other • To be built upon existing network technology • Part of the nation’s critical infrastructure

  6. Who May Use NHIN? • Healthcare professionals use it to diagnose and treat patients (e.g. telemedicine, home healthcare) • Healthcare professionals use it to access/update/transfer electronic health records (EHR) and other personal health information (PHI) • Patients use it to access/verify EHR information and other PHI • Public health officials use it to broadcast healthcare/epidemiological alerts and healthcare-related information • Medical/emergency first responders use it to obtain PHI in emergency situations • Healthcare providers and insurors use it to submit/process/pay insurance claims • Public health agencies use it to obtain information on quality of healthcare • Pharmacists may use it to fill prescriptions electronically

  7. Fast, Ubiquitous Access to online Electronic Health Records Online Claims Processing Transport of Medical Images Emergency Medical Response Coordination of Health Information Networks Telehealth for rural/underserved areas Longitudinal EHR Home Healthcare E-Prescription Functions of the NHIN Source: Position Statement: National Health Information Network, with emphasis on Security and Privacy Issues, June 2005

  8. Interoperability Considerations

  9. Interoperability Considerations (cont)

  10. Known Gaps in the Interoperability Picture • QOS/Bandwidth Requirements for video transmission – IEEE 802.1ah is working on QOS standards for streaming multimedia over Ethernet • Network Reliability – no known standards • Need to identify NHIN as part of national critical infrastructure

  11. Other Areas for Investigation • New Protocols? • Standards for lossless imaging? • Security Standards? • Encryption? • Standards for network compatibility? • Compatible storage formats?

  12. Moving Forward… • Recommendations for action: • Position paper on interoperability – complete by Nov/Dec 2005 • White paper on interoperability for greater depth • Recommendations/liaisons to standards bodies – IEEE Reliability Society, Critical Infrastructure Committee, 802.1ah • Request input from NCHIT, HHS, CDC, FDA, etc. on requirements • Other?

  13. Recommended Reading • Semantics: Chen C., “Visualizing Semantic Spaces and Author Co-Citation Networks in Digital Libraries,” http://www.pages.drexel.edu/~cc345/papers/ip_m/ip_m.pdf • IEEE 802.1ah: Cherry S., “Ethernet’s High-Wire Act,” IEEE Spectrum, April 2005, 63-5. • Critical Infrastructure: • Miller et al, “Toward Interoperable First Response,” IEEE IT Professional, Jan/Feb 2005, 13-20. • Kun L. and Bray D., “Information Infrastructure Tools for Bioterrorism Preparedness,” IEEE Engineering in Medicine and Biology, Sept/Oct 2002, 69-85. • Kun L., “Technology and Policy Review for Homeland Security,” IEEE Engineering in Medicine and Biology, Jan/Feb 2004, 30-44. • PHIN: Snee N. and McCormick K., “The Case for Integrating Public Health Networks,” IEEE Engineering in Medicine and Biology, Jan/Feb 2004, 81-88. • National Health Information Infrastructure: http://www.hsrnet.net/nhii

  14. Related Pending Legislation • [Enzi] Better Healthcare Through Information Technology Act • S.1262, Health Technology to Enhance Quality Act of 2005 • S.1223, Information Technology for Health Care Quality Act • S.1227, Health Information Technology Act of 2005 • HR2234, 21st Century Health Information Act of 2005 • HR1251, Connecting the Operations of National Networks of Emergency Communications Technologies for First Responders Act of 2005 • HR747, National Health Information Incentive Act of 2005 • HR2807, Medicare Telehealth Enhancement Act of 2005

  15. Contact Info Thomas C. Jepsen, IEEE-USA Medical Technology Policy Committee tjepsen@ieee.org Phone: 919-933-0377

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