Automate Blue Button Initiative Push Workgroup Meeting

1. Automate Blue Button InitiativePush Workgroup Meeting November 26, 2012

2. Meeting Etiquette From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute  All Panelists • 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 • Hold = Elevator Music = frustrated speakers and participants • This meeting is being recorded • 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. • Send comments to All Panelists so they can be addressed publically in the chat, or discussed in the meeting (as appropriate). 2

3. Agenda

4. Announcements and Reminders • Meeting Reminders • Push Workgroup Meetings are Mondays from 2:00 – 3:00 pm Eastern. • Direct Connect-a-Thon (December 6, 2012) • ABBI Face to Face (December 11, 2012 from 2:30-4 pm) • The next Community Meeting will be held as needed. • Meeting information is on the Automate Blue Button Wiki Page: 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 • Comment period ends Wednesday, November 28th. 4

5. Looking ForwardABBI Schedule • November • October 22- November 19: Drafting and comment period on ABBI Implementation Guide (Part 1: Send via Direct + Content) • Nov 19th : BEGIN Comment Period Round 2 on ABBI Implementation Guide (Part 1: Send via Direct, Content) • 26th : Discuss Comments in workgroup calls • 28th : END Comment Period on ABBI IG (Part 1) • December • 3rd : Review Implementation Guide Comments in Workgroup Calls and Finalize Guide • 6th :ABBI Participates in Connect-a-thon • 10th :“Public Release” of ABBI Implementation Guide (Part 1) • 11th : ABBI Participates in Town Hall @ ONC Annual Meeting • 21st : BEGIN Comment Period on ABBI Implementation Guide (Part 2: Send via Email, Payer Content, and Developer Toolkit) • January • ~ 10th: END Comment Period on ABBI Implementation Guide (Part 2) • ~ 15th : 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. Flow 1: Patient Portal 1. Patient logs into portal

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

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

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

10. Flow 1: Patient Portal 5. Flow Complete

11. Flow 1: Patient Portal 1. Patient logs into portal 2. Patient clicks on “Share with Direct” 4. Patient enters Direct address and selects transmit frequency 3. Patient reads and accepts transmit terms

12. Flow 2: Provider

13. Flow 2: Provider

14. Flow 2: Provider

15. Flow 2: Provider

16. Open Question: Payload • Push • Multi-part MIME • application/xml+ccda • Message Body: • This message was sent by [Data Holder Name] at the request of [Patient Name] to [Direct Address]. • (Optional) It includes: [List of Files]. • Structured Version? • Data Holder Name • Patient Name • Direct Address • Array of Files

17. Open Challenge: Sending securely to any address • Transmit will have two approaches • When a transmission occurs, the HISP will pull down the organizational level certificate and self-signed certificate • Org: (Verisign example.org) • Self: (Example.org  someone@example.org) • (1) If the self-signed certificate matches a trust anchor that has already been loaded into the HISP, it will send the message that way. • (2) If the self-signed cert is not in the system, it will use the organizational cert to encrypt the message. It will also include the destination address in the payload.

18. Open Challenge: Sending securely to any address • 3rd Party Applications / Locations • Need to exchange their anchors • Need to make their self-signed certificates discoverable via DNS and LDAP • Need to obtain a SSL certificate from CA • Need to make that org certificate discoverable via DNS and LDAP • Need to parse message to ensure it was delivered to right location

19. Next Steps / Reminders • Next Steps • Provide Feedback to revised Implementation Guide • Focus on Workflow • Meeting Reminders • Next PUSH Workgroup Meeting is Monday, December 3rd, 2012 @ 2:00 pm Eastern. • The next Community Meeting will be held as needed. • http://wiki.siframework.org/Automate+Blue+Button+Initiative • Upcoming Face-to-Face Opportunities: • Dec 6th – 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) • Presidential Innovation Fellow: Ryan Panchadsaram (ryan.panchadsaram@hhs.gov) • Project Manager: Jennifer Brush (jennifer.brush@esacinc.com) • S&I Admin: ApurvaDharia (apurva.dharia@esacinc.com)

20. ABBI Push Back-up Slides

21. PUSH Current Status Pre-Discovery • Agreed and voted on charter, including • Scope • Timeline • Deliverables Discovery • 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 Reference Implementations • 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 • Refine use cases based on reference implementations • Refine implementation guide based on reference implementations Implementations • 3-6 full implementations that reflect implementation guidance 21

22. PushWorkgroup • PUSH Dashboard Next Steps Status • 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 Timeline Pilots Identified & On Track Outstanding Issues Oct-12 Nov-12 Jan-13 Feb-13 Sep-12 Dec-12 Mar-13 WG Launch (09/17) Reference Implementations using Direct Draft Implementation Guidance Use Case 1 Definition (DIRECT @ Physician’s Office) Finalize Implementation Guidance for Direct Full implementations with providers / Payers Use Case 2 Definition (DIRECT via Patient Portal) Reference Implementations using Email Use Case 3 Definition (Email) UC3 Implementation Guidance for Email Discovery Pilot & Implementation Guidance Implementation 22 S&I Framework Lifecycle

23. PushWorkgroup • PUSH Current Deliverables • Implementation Guide http://wiki.siframework.org/file/view/ABBI+IG+-+Transmitting+Data+Using+the+Direct+Protocol+2012-11-15.docx http://wiki.siframework.org/file/view/ABBI+IG+-+Receiving+Health+Data+Using+the+Direct+Protocol+2012-11-15.docx 23