NHIN Specifications

1. WEDNESDAY, 3:30 – 3:50PM NHIN Specifications Richard Kernan, NHIN Specification Lead (Contractor), Office of the National Coordinator for Health IT Karen Witting, Contractor to the North Carolina Healthcare Information and Communications Alliance (NCHICA), NHIN Specifications Factory

2. NHIN Specification Framework Service Oriented Architecture (SOA) approach results in a framework of NHIN Specifications • Modular design, based largely on IHE Technical Framework • NHIN specifications instantiated in a NHIN Gateway • Scope covers inter-gateway exchange only • Implementations may vary to accommodate business needs HIMSS 2010

3. NHIN Specification Framework Transaction Profiles Utilize exchange patterns for specific transactions CMS CARE Doc Submission CDC GIPSE HIEM MITA Eligibility Verification Discovery and Information Exchange Services Rely on foundations to enable exchange patterns Pub/Sub Push Discovery Pull HIEM Patient Discovery Services Registry Query & Retrieve Docs Eligibility Verification Doc Submission Messaging, Security, & Privacy Foundations Enable private, secure, and interoperable communication of health information Messaging Platform Authorization Framework Designates Pilot Use HIMSS 2010

4. Messaging, Security, and Privacy Foundations Messaging Platform defines how NHIN nodes must authenticate each other and encrypt the information exchanged between them Leverages widely-used standards for message transport and security Messaging, Security, & Privacy Foundations Enable private, secure, and interoperable communication of health information Messaging Platform Authorization Framework HIMSS 2010

5. Messaging, Security, and Privacy Foundations Authorization Framework describes how nodes must provide each other with information needed to inform local authorization decisions Local Autonomy • Decision to release information is that of the responding node; must be supplied with information characterizing request initiator Local Accountability • Initiating node accountable for accuracy of info provided to responder Messaging, Security, & Privacy Foundations Enable private, secure, and interoperable communication of health information Messaging Platform Authorization Framework HIMSS 2010

6. Discovery and Information Exchange Services • Services Registry Interface – means for nodes to interact with UDDI Registry for node and endpoint discovery • Patient Discovery – provides a means for a NHIN node to query another to determine if it is a source of information for a specific patient • Query & Retrieve Docs – an exchange pattern that allows NHIN nodes to locate and retrieve patient-specific clinical documents held by other NHIN nodes Discovery and Information Exchange Services Rely on foundations to enable exchange patterns Pub/Sub Push Discovery Pull HIEM Services Registry Patient Discovery Query & Retrieve Docs Eligibility Verification Doc Submission Designates Pilot Use HIMSS 2010

7. Discovery and Information Exchange Services • Eligibility Verification – an exchange pattern that allows NHIN nodes to determine if a patient is eligible for health plan coverage • Document Submission – a push mechanism that allows an initiating NHIN node to send one or more documents for a given patient to a receiving node • Health Information Event Messaging (HIEM) – a publish/subscribe exchange pattern that allows a NHIN node to establish a subscription to information held by another node for periodic exchange Discovery and Information Exchange Services Rely on foundations to enable exchange patterns Pub/Sub Push Discovery Pull HIEM Services Registry Patient Discovery Query & Retrieve Docs Eligibility Verification Doc Submission Designates Pilot Use HIMSS 2010

8. Transaction Profiles Transaction Profiles Utilize exchange patterns for specific transactions CMS CARE Doc Submission CDC GIPSE HIEM MITA Eligibility Verification Designates Pilot Use HIMSS 2010

9. WEDNESDAY, 3:30 – 3:50PM NHIN Scenarios

10. Scenario 1: New Patient Identify Target NHIN Nodes New Patient Search for NHIN Nodes in local states List of local NHIN Nodes and electronic information exchange services available HIMSS 2010

11. Scenario 1: New Patient Discover Source of Patient Information New Patient Search for NHIN Nodes in local states List of local NHIN Nodes and electronic information exchange services available Request each target NHIN Node identify a local matching patient Identify which target NHIN Nodes which have a matching patient HIMSS 2010

12. Scenario 1: New Patient Search for Relevant Documents Identify which target NHIN Nodes which have a matching patient Each NHIN Node responds with queried documents for patient match List of documents available for the new patient HIMSS 2010

13. Scenario 1: New Patient Retrieve Specific Documents List of documents available for the new patient Request documents of interest Clinical content needed to support the new patient is available to the provider HIMSS 2010

14. Scenario 2: Submit Patient CARE Summary Sent to CMS NHIN Node Continuity Assessment Record and Evaluation (CARE) document generated Document delivered to CMS Patient released Document verification returned to sender CMS HIMSS 2010

15. The participation of any company or organization in the NHIN and CONNECT area within the HIMSS Interoperability showcase does not represent an endorsement by the Office of the National Coordinator for Health Information Technology, the Federal Health Architecture or the Department of Health and Human Services. Thank You