CMS’ C-HIEP Proof-of Concept

1. TUESDAY, 4:30 – 5:30PM CMS’ C-HIEP Proof-of Concept CMS Implementation of NHIN CONNECT Anita Griner, Senior Project and Program Manager Centers for Medicare & Medicaid Services Nitin Jain, C-HIEP Executive Consultant (Contractor) Centers for Medicare & Medicaid Services

2. Session Objectives 1 C-HIEP Overview 2 Technical Components 3 NHIN Integration into CMS 4 Challenges, Lessons Learned and Next Steps 1 HIMSS 2010

3. Continuity Assessment Record & Evaluation CARE Health Information Exchange Project HIEP What is C-HIEP? • Proof-of-concept • Align with national standards for data interoperability • Move towards a uniform, harmonized data set • Move towards enhancing the ability for communication and coordination of care across settings 17 HIMSS 2010

4. C-HIEP Participants CMS: Project Owners Contractor: Technical HIOs: Participants 20 HIMSS 2010

5. C-HIEP CONOPS HIO Provider Settings: • Nursing Facilities (including skilled) • Home Health Agencies • Inpatient Rehab Centers • Long Term Care Hospitals • Acute Hospitals • Physicians Offices • Outpatient settings Provider Settings: • Nursing Facilities (including skilled) • Home Health Agencies • Inpatient Rehab Centers • Long Term Care Hospitals • Acute Hospitals • Physicians Offices • Outpatient settings HIO HIO CMS HIMSS 2010

6. Technical Details Data Interoperability: • HITSP C83 Content Specificationhttp://hitsp.org/ConstructSet_Details.aspx?&PrefixAlpha=4&PrefixNumeric=83 Exchange Interoperability: • NHIN Specification: Document Submission Service Interface Specification (new “push” model)Based on: IHE CROSS-ENTERPRISE DOCUMENT RELIABLE MESSAGING (XDR) • NHIN messaging platform and authorization framework components:Including: SOAP messaging, SAML Assertion, 2-way SSL HIMSS 2010

7. Analytics Reporting & Dashboards • Store Native Doc • Transform Doc • Store Data Objects Document Submission CHIEP Assessment Data Analytics Persist Acknowledgement Acknowledgement De-Identify CHIEP Assessments Latent Response CHIEP Database C-HIEP Information Flow Long Term Care Hospital Physician Encounter Summary Discharge Summary Security • Authorize User • Validate Message HIO Validate Assessment Data • Check Duplicate • Check De-identification • Check Patient Eligibility • Validate Metadata • Validate Document Validate Create C-HIEP Assessment Documents • Build Accept/Reject Response • Return Response Reply HIMSS 2010

8. C-HIEP 3 Zone Architecture HIMSS 2010

9. C-HIEP Challenges to Date Participants • Differences in technical maturity, business models capabilities, and data availability/interoperability Specifications • No “Push” NHIN Spec Available (i.e. Query and Retrieve, HIEM) • No existing HITSP specification aligned to CARE/C-HIEP data set Policy • Privacy: Requirement to de-identify C-HIEP data challenging for case-threading • NHIN DURSA Technical • Larger data volumes available than anticipated • Maturity of NHIN & compatibility within CMS HIMSS 2010

10. Next Steps • Continue technical development and testingof C-HIEP components • Production data submission from HIOs to begin summer ‘10 • Continued work on data set and standards for interoperability • Gathering of lessons learnedand re-aligned objectives for future phases of the CARE data set HIMSS 2010

11. 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