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Direct and the Nationwide Health Information Network Session 11

Direct and the Nationwide Health Information Network Session 11. April 13, 2011. Agenda. What is the Nationwide Health Information Network? What health information exchange scenarios will the Nationwide Health Information Network help address?

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Direct and the Nationwide Health Information Network Session 11

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  1. Direct and the Nationwide Health Information NetworkSession 11 April 13, 2011

  2. Agenda • What is the Nationwide Health Information Network? • What health information exchange scenarios will the Nationwide Health Information Network help address? • What are the tools in the Nationwide Health Information Network toolkit? • How does Direct fit into the Nationwide Health Information Network toolkit? • What are the clinical Use Cases for health information exchange? • How can Direct be used to enable a variety of use cases? • How can other tools address more complex use cases? • How will Direct work at scale? • MEDfx Presentation: Integrating Direct and CONNECT • Mark Bamberg, VP Research and Development, MEDfx • Q&A • Poll

  3. What is the Nationwide Health Information Network? • A set of policies, standards and servicesthat enable the Internet to be used for secure and meaningful exchange of health information to improve health and health care. • Enables a variety of health information exchange scenarios – from less complex to very robust

  4. What scenarios will the Nationwide Health Information Network help address? Very Robust Scenarios • Each health information exchange scenario requires a different “tool” from the Nationwide Health Information Network “toolkit”; e.g., Direct, Exchange, etc. • Each tool must be used in conjunction with a coherent set of: • Standards • Services • Policies • Trust Fabric Cross-Community Access Longitudinal data access across settings of care within a community Directed Exchange with Value-Added Intermediaries Directed Exchange Less Complex

  5. What are the tools in the Nationwide Health Information Network toolkit? Very Robust Scenarios Tools Query for Documents Patient Discovery Cross-Community Access Longitudinal data access across settings of care within a community Retrieve Documents Direct Directed Exchange with Value-Added Intermediaries Document Submission* Directed Exchange Less Complex * Not currently in Nationwide Health Information Network toolkit

  6. How does Direct fit into the Nationwide Health Information Network toolkit? The Direct Project provides HIEs with a low cost way to enable simple push messaging to their healthcare constituents The Direct Project doesn’treplaceother ways information is exchanged electronically today, but it might augmentthem The Direct Project supports speedy adoption and simple use cases(e.g., provider referrals), but other methods of exchange might be better suited for other scenarios (e.g., real-time population health statistics) The Direct Project was designed to coexist gracefully with existing protocols for data exchange, e.g., web services, client-server, etc. The Direct Project seeks to replace slow, inconvenient, and expensive methods of exchange (e.g., paper and fax) and provide a future path to advanced interoperability. Though not technically incorporated yet, Direct Project specifications are expected to be incorporated into the NwHINspecifications Cross-Community Access Directed Exchange Longitudinal Data Access across a Community Directed Exchange with Valued-Added Intermediaries Health information exchange: a puzzle with many pieces

  7. How can Direct be used to enable a variety of use cases?

  8. How can other tools address more complex use cases?

  9. How will Direct work at scale? • Scalable Trust: • Standards-based certificates • Policies for issuance of certificates • Scalable Directories: • DNS-based Directories at first • Interoperable statewide directories with certificate lookup next • Upcoming S&I Framework initiatives targeted at both of these topics

  10. MEDfxPresentation

  11. Presentation Goals • Involvement with Direct • Involvement with CONNECT • Evolution of the Direct / CONNECT integration • How the integrated solution works

  12. Involvement with Direct • MEDfx involved from beginning in CONNECTathons • Joined Direct in September 2011 • Implementation Group • Reference Implementation WG • Implementation Geographies WG • Provided Install for Java Bare Metal Direct Reference Implementation • Initiates Direct Project Pilot for Virginia Region • MEDfx, Verizon, MedVirginia, and Dominion • Supports Referral to Patient Centered Medical Home • Integrated support with Lifescape Portal • Demonstrates Direct / CONNECT solution at HIMSS 2011

  13. Involvement with CONNECT • SSA Disability Claims Use Case • MedVirginia provides C32 to SSA via the NwHIN • Proprietary NwHIN Gateway • July 2009 MEDfx integrates MedViriginia with CONNECT 2.0 • Supports • SubjectDiscovery • DocQuery • DocRetreive • CHIEP • MedVirginia submits C83 to CMS for Patient Discharge Events • Upgrades to CONNECT 2.4 • July 2010 MedVirgina goes into production • Supports • Patient Discovery • DocQuery • DocRetrieve • XDS.b • Provide and Register Document Set • Retrieve Document

  14. Involvement with CONNECT cont. • Virtual Lifetime Electronic Record (VLER) • MedVirginia provides full NwHIN support to VA and DoD • Supports SSA, VA and Dod with single CONNECT instance • Adds Centra as subordinate HIE through MedVirginia

  15. CONNECT 2.0 Deployment SSA Solution 1 CONNECT NwHIN Subject Discovery Document Query Document Retrieve HTTPS MedVirginia Portal

  16. CONNECT 2.4 Deployment VA Patient Discovery Document Query Document Retrieve SSA Solution 1 CONNECT NwHIN DoD HTTPS CMS MedVirginia Portal XDS.b Provide And Register Document Set Review Document

  17. Legacy Integration MedVirginia HISP Dominion HISP SMTP SMTPS SMTPS SSL SSL DOD Solution 1 Interchange Solution 1 Interchange VA NwHIN Lifescape CONNECTfx Lifescape SSA HTTPS HTTPS MedVirginia Portal Dominion Portal

  18. Target Architecture HISP 1 HISP 2 SMTP SMTPS SMTPS SSL SSL DOD Interchange Oracle HTB Oracle OHMPI Interchange VA NwHIN Lifescape CONNECTfx Lifescape SSA HTTPS HTTPS MedVirginia Solution2 Portal Verizon Lifescape Portal

  19. Capabilities • RIM HL7v3 CDR • Documents available via CONNECT • Ability to shred Documents into CDR via Direct • Ability to share Direct Sourced Documents • Ability to share C32 with content from structured Direct Sourced Documents • Low overhead installation • Scalable

  20. Q&A

  21. Poll

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