FHA/NHIN Review and Suggested Pilot

1. FHA/NHIN Review and Suggested Pilot Brand Niemann, US EPA, Enterprise Architecture Team, and Chair, Semantic Interoperability Community of Practice (SICoP) Best Practices Committee (BPC), Federal CIO Council July 27, 2006 (Updated August 8th)

2. Overview • 1. Brief History • 2. Recent FHA/NHIN • 3. Suggestions to the NCVHS • 4. Moving Forward on the Pilot • 5. Questions & Answers Dialogue • 6. Updates

3. 1. Brief History • ONCHIT Ontologies for Interoperability Pilot and Response to RFI with the Ontolog Forum (January 18, 2005): • Interesting, but not used in RFI. • NHIN RFI Semantic Analysis (April 5, 2005): • Interesting, but not used. • FHA Data Architecture Working Group (February-March 2006): • Finally want to do ontologies, but stopped because it was out ahead of the rest. • Open Group – SICoP Conference (April 27, 2006): • Electronic Health Record Using Semantic Technologies Use Case. • First NHIN Forum (June 27-28, 2006): • Comments at Forum and Testimony to NCVHS. • HITOP (today): • Lets continue to move forward.

4. 2. Recent FHA/NHIN • Strategic Overview – Slide 5: • Hard to read! • FHA Participation Illustration – Slide 6: • Hard to understand! • 1st Nationwide Health Information Forum: Functional Requirements – Slide 7: • Hard to read again and services should be the focus. • Consolidated Health Informatics (CHI) Work Group Meeting – Slide 8: • How does one really track all of this work and use it? • How about a Semantic Wiki? RHIO, NIH, etc. are using Wikis! • Awards for EHR Systems – Slides 9-10 • How about adopting some of these Best Practices?

9. Awards for EHR Systems • The Department of Veterans Affairs' model system of electronic health records is one of only seven government initiatives to receive this year's prestigious "Innovations in American Government Award." The annual award, sponsored by Harvard University's Ash Institute for Democratic Governance and Innovation at the Kennedy School of Government and administered in partnership with the Council for Excellence in Government, honors excellence and creativity in the public sector. • http://www1.va.gov/opa/pressrel/docs/Innovations_Award.doc • http://www.innovations.va.gov/

10. Awards for EHR Systems • 8th Annual Government Solutions Center Pioneer Award Winners Luncheon being held at the itsGov "Technology Buying at Year-End" Event on July 26 at the Ronald Reagan Building. This year's awardees were selected for their innovative use of technology in government programs through COTS solutions or other technology applications (2 of 9): • Clinical Information Technology Program Office (CITPO), AHLTA, the Military Electronic Health Record. • Joint Medical Information Office, Theater Medical Information Program.

11. 3. Suggestions to the NCVHS • Ask the FHA what Service Components it has identified from its FEA work and consider reusing, repurposing, etc. for the NHIN to save money and development time. • Construct a matrix of HealthIT Standards versus NIST Standards Criteria (level of consensus, product availability, stability, and problems / limitations) and use that to judge standards maturity and guide multiple vendor-standards pilots. • Architect at the EHR document level as well as at the system level. • Follow the Axiom from Systematics that says: A complex system built from scratch will never work, while a complex system built from a simple system that works will work. • Architect a service that is simple enough to work for consumer health interests at the edge of the network, but also versatile enough to be useful at the core of the network.

12. 3. Suggestions to the NCVHS • Consider dealing with Privacy / Confidentiality of EHR that same way the Census Bureau does with Census data. • Do the four vendor pilot actually work and can they be readily made to interoperate with one another? • This is to mantra for the piloting that SICoP follows - open collaboration with open standards in multiple vendor - multiple open standards pilots. • Provide for implementation of new technologies (e.g. IPV6, RFID, and Semantic Technologies) in the Pilots.

13. 4. Moving Forward on the Pilot • Lets Bring in More People and Groups and Try Again with the FHA/NHIN. • Lets Use the Best Medical Ontologists and Their Ontolgies: • E.g. Dr. Mike Cummens, August 15th Workshop. • Lets Mine the FHA eCommunity Content for the Semantic Wiki: • http://fha.mitre.org/ecommunities/index.jsp • http://vkwiki.visualknowledge.com/ • Log-in: krecsky@visualknowledge.com • Lets Present This at the October 10-11th Fifth Semantic Interoperability for E-Government Conference and Elsewhere.

14. 5. Questions & Answers Dialogue • Your Turn Now or Later. • Contact Information: • Brand Niemann, U.S. EPA • 202-564-9491, niemann.brand@epa.gov • Personal Wiki Page: • http://colab.cim3.net/cgi-bin/wiki.pl?BrandNiemann • Web Site / Blog: • http://web-services.gov/ • Semantic Interoperability CoP Wiki Page: • http://colab.cim3.net/cgi-bin/wiki.pl?SICoP

15. 6. Updates • August 3rd, 2006: Microsoft VISTA supports devices for home health care with security and privacy protection. • Note: We will need more of this if there is a pandemic, people who can’t afford hospital care, or those that choose hospice services. • July 31st, 2006: The Senate directed DoD to adopt the Department of Veterans Affairs’ electronic health records architecture in its version of the fiscal 2007 appropriations bill approved by the Senate Appropriations Committee’s Military Construction and Veterans Affairs Subcommittee.

16. 6. Updates • August 1st, 2006: The Healthcare Information and Management Systems Society (HIMSS) and Internet2 announce collaboration to create an Advanced and Interoperable Medical Network. • July 27th, 2006: Microsoft to Buy Medical Software: Azyxxi, software that collects and displays patient records from hundreds of sources, was developed by doctors at the Washington Hospital Center. • This was a basic idea for the SICoP / HITOP Semantic Technology EHR / EMR Pilot!