HIT Standards Committee

1. HIT Standards Committee DRAFT: S&I Framework Principles and Processes

2. S&I Framework KICK-OFF

3. S&I Mission Promote a sustainable ecosystem that drives increasing interoperability and standards adoption Create a collaborative, coordinated, incremental standards process that is led by the industry in solving real world problems Leverage “government as a platform” – provide tools, coordination, and harmonization that will support interested parties as they develop solutions to interoperability and standards adoption.

4. ONC Standards and Interoperability Framework Pilot Demonstration Projects (Lockheed Martin) Standards Development (TBD) Reference Implementation (Lockheed Martin) Harmonization ofCore Concepts (Deloitte) Implementation Specifications (Deloitte) Certificationand Testing (Stanley/Deloitte) Use Case Developmentand Functional Requirements (Accenture) Tools and Services(Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository, Testing Scripts, etc) (Stanley)

5. Standards and Interoperability Organizational Structure Standards and Interoperability Standards National Health Information Network Certification and Testing FHA Standards Teams NHIN Teams Certification Team FHA Teams CONNECT (TBD) Architecture Use Cases (Accenture) Certification (Stanley/Deloitte) Reference Implementations (Lockheed Martin) Standards Development (TBD) Test Infrastructure (Stanley/Deloitte) Emergent Pilots (Lockheed Martin) Harmonization (Deloitte) Tools (Stanley) Spec Factory (Deloitte) Operations (Stanley)

6. What is an IEPD? • An Information Exchange Package Documentation (IEPD) is a collection of artifacts that describe the construction and content of an information exchange • Developed to provide the business, functional, and technical details of the information exchange through predefined artifacts • Created with a core set of artifacts in a prescribed format and organizational structure to allow for consistency • Designed to be shared and reused in the development of new information exchanges through publication in IEPD repositories • IEPDs contain design specifications for an information exchange but may not include supplementary information such as implementation decisions.

7. The IEPD Artifacts IEPDs contain both required and recommended artifacts Required : Bold Recommended : Italic Note: Best practices for most organizations include many of the optional artifacts listed here Scenario Planning • Business Process • Use Cases • Sequence Diagrams Analyze Requirements • Business Rules • Business Requirements Map & Model • Exchange Content Model • Mapping Document Build & Validate • Subset Schema • Exchange Schema • XML Wantlist • Constraint Schema • Extension Schema • Main Document • IEPD Catalog • IEPD Metadata • Sample XML Instances • XML Stylesheets Assemble & Document No required artifacts. Publish the IEPD to a repository and implement the exchange Publish & Implement

8. S&I NIEM Harmonization Strategy Human Services Human Services ONC’s Office of Interoperability and Standards is building a Health Information Exchange Model (NIEM Health) that is harmonized with NIEM Health and Human Services petal to serve as bridge between NIEM and NIEM Health

9. S&I NIEM Process Harmonized S&I Development Phases Participants Release & Publication Capability Formulation Capability Elaboration Construction Assemble & Document Map & Model Pub. & Impl. Scenario Planning Analyze Requirements Build & Validate NIEM Lifecycle Use Case Development Harmonization Spec Development Reference Impl Cert &Testing Health Community S&I Governance

10. Addressing Challenges for the Health Information Exchange Model

11. Requirements for a Model Centric Approach • The modeling approach used by the S&I Framework must • Provide traceability from Use Case and Requirements through to one or more implementations • Provide semantic and syntactic modeling constructs to support defining the information and behavior that are part of exchanges • Support the need to harmonize with existing standards defined at different levels of abstraction • Be adoptable by different organizations • Be able to integrate into NIEM process

12. Model-Centric Solution - MDA • Base S&I Framework modeling on the 3 OMG/MDA model abstractions. • Computational Independent Model (CIM) • Platform Independent Model (PIM) • Platform Specific Model (PSM) • Define a mechanism to show traceability from Use Cases and Functional Requirements through to technical bindings defined in a PSM. • Define a flexible modeling foundation by which different types of specifications can be defined. • Provides ability for multiple technology bindings for the same set of logical specifications (multiple PSMs)

13. Behavior Model Domain Model Web Services Schema and WSDL Use Case Model, Interaction Model, Domain Model Vision Document, Process Model Main Document, IEPD Catalog, IEPD Metadata, Sample XML Exchange Schema, Subset/Constraint Schema, Business Processes, Use Cases Business Rules, Business Requirements Exchange Content Model, Mapping Document Model Centric Solution - NIEM S&I Activities NIEM Processes and Artifacts Specification Models Scenario Planning Use Case Developmentand Functional Requirements CIM Harmonization ofCore Concepts Analyze Requirements Map and Model Implementation Specifications PIM Build and Validate Reference Implementation and Pilots PSM Assemble and Document Certification and Testing Publish and Implement

14. Prioritization and Backlog Lists Strategic Priorities Operational Priorities “Day to Day” Priorities within each functional team

15. What’s Next Pilot Demonstration Projects Standards Development Reference Implementation Harmonization ofCore Concepts (NIEM framework) Implementation Specifications Certificationand Testing Use Case Developmentand Functional Requirements Scenario Planning Map & Model Analyze Requirements Build & Validate Assemble & Document Publish & Implement NIEM IEPD Lifecycle Create a NIEM Health standards harmonization process and governance framework Establish roadmap for existing NHIN standards, MU harmonization, and non-MU health information exchange specifications Establishes a repeatable, iterative process for developing widely reusable, computable implementation specifications Establishing the tooling and repositories needed Establishing the practices and guidelines for modeling Enables semantic traceability so that useable code can be traced back to original requirements and definitions Promotes transparency and collaboration from broad range of health stakeholders

16. S&I Framework CURRENT LESSONS

17. Lessons Learned: NHIN Direct • Consensus Driven Process • Open Collaboration • Established core guiding principles • Driven by business needs and elaborated use cases • Real world pilot implementation • Establish executive sponsorship and workgroup leads Focused Collaboration Commandand Control Focus A Thousand Flowers Bloom Classic Trade-Off Low High Participation Low High

18. Lessons Learned: Eligibility and Enrollment • Dedicated resource(s) to drive project and decision making • Clearly defined problem statement at project initiation • Define expectations for desired artifacts • Promote community enthusiasm • Leverage tools to increase efficiencies Focused Collaboration Commandand Control Focus A Thousand Flowers Bloom Classic Trade-Off Low High Participation Low High

19. S&I Framework ISSUES TO DISCUSS

20. Issues and Challenges (1) • Issues and Challenges • How and when do we get input from other stakeholders including those outside of meaningful use? • VLER • Federal partners • Other stakeholders • How do we foster multiple working groups and create a unified view of priorities? HITPC HITSC Coordination Priority Setting Evaluating Artifacts S&I Framework Sustainable Operations Shared Infrastructure

21. S&I Framework Challenges (2) How do we create simple, easy to implement specifications that will drive adoption? • How do we facilitate access to SDO standards for providers and support sustainable business models? • Engaging the SDO community • Developing a “one stop shop” for implementation specifications • How do we foster community and industrial participation to support balanced representation and diverse priorities? • Identifying champions for S&I lifecycle initiatives • Engage communities throughout S&I Framework • Identifying demonstrable pilot programs • Engaging and incentivizing volunteers from existing community

22. S&I Framework Open Questions cont. • What are the appropriate interface points with HITSC through S&I Framework lifecycle? • Establish priorities, approve implementation specifications, • Identifying appropriate decision makers at S&I control points • Identifying appropriate roles and participants in the governance of S&I Framework • How do we identify and select tools as shared resources that foster collaboration? • Establishing and adhering to agreed upon modeling conventions • Tools to support artifact lifecycle management and dissemination • How do we extend NIEM to accommodate needs of health care domain?

23. S&I Framework Priorities Prioritization needs to accommodate broad stakeholder needs, account for breadth and depth of available expertise, and support a long term growth strategy • What should our priorities be for the next six months, twelve months, twenty-four months? From among… • Meaningful Use Stage 1 • Meaningful Use Stage 2 & 3 • NHIN Exchange • NHIN Direct • Health Care Reform • VLER • New use cases (lab, pharmacy, content specifications)