IHE IT Infrastructure Outreach to <enter domain/deployment> Committee

1. IHE IT Infrastructure Outreach to<enter domain/deployment> Committee <your name here>IT Infrastructure Planning Committee Updated March 2010

2. Objectives of this Presentation • To build awareness of the IT Infrastructure (ITI) Domain • To establish an ongoing liaison between ITI and your domain/deployment committee • To begin a conversation about your committee’s strategic planning, and how ITI can support your committee to achieve your objectives

3. IT Infrastructure Domain (ITI) • Supports profiles which supply necessary infrastructure for sharing healthcare information. • IT Infrastructure domain began in 2003 and now has 27 profiles that it supports. • An infrastructure Interoperability component… • Represents a common IT function or service that is used as a building block for a variety of use cases • May be imbedded in an application, but is often deployed as a shared resource • Is a necessary ingredient, but is rarely visible to the end user

4. Scope of the ITI Domain • The ITI domain addresses the implementation of standards-based interoperability solutions to improve information sharing, workflow and patient care. • Efforts have been focused on the following categories: • Patient and Provider Identity • Health Record Sharing • Security and Privacy • Workflow Enablers • Support Management

5. Patient & Provider Identity • Profiles in the Patient and Provider Identity category support the management of patient, provider and healthcare organization identity including their localization. This includes the ability to look up, cross-reference, update, remove, merge, link and general management of identities.

6. Health Record Sharing • Profiles in the Health Record Sharing category support the ability to share patient specific healthcare information within and across Enterprises. This includes the ability to submit, locate/list, push, pull and retrieve patient specific healthcare information.

7. Security & Privacy • Profiles in the Security and Privacy category support the ability to ensure that healthcare information is managed consistent with a reasonable set of security and privacy policies.

8. Workflow Enablers • Profiles in the Workflow Enablers category support standard sequences for performing workflow activities.

9. Support Management • Profiles in the support management category support the ability to share information needed for interoperable healthcare management such as clinical coding, technical or IT management information

10. Categories of Healthcare Communication Services Patient and Provider Identity Management Regional Infrastructure Hospitals Security/Privacy e.g. order lab test, track status and receive results e.g. access last 6 mo. historical labs & encounter summaries e.g. get current list of allergies or med list from source Support Management Health Record Sharing Workflow Management Workflow Enablers Specific health records snapshot provided on demand Source persisted and attested health records Document Sharing Dynamic Information Access 2 or more entities synchronize a task

11. ITI Profiles • Security/Privacy • Cross-Enterprise User Assertion (XUA) ☼ • Basic Patient Privacy Consents (BPPC) ☼ • Enterprise User Authentication (EUA) • Audit Trail and Node Authentication (ATNA) ☼ • Document Digital Signature (DSG) • Patient and Provider Identity • Personnel White Pages (PWP) • Patient Identifier Cross-Referencing (PIX)☼ • Patient Demographics Query (PDQ) ☼ • Patient Identifier Cross-Referencing HL7 V3 (PIX V3)☼ • Patient Demographics Query HL7 V3 (PDQ V3) ☼ • Patient Administration Management (PAM) • Pediatric Demographics Option • Cross-Community Patient Discovery (XCPD) ☼ ▀ colored text designates 2009 new profiles ☼ Designates profiles being demonstrated at HIMSS Interoperability Showcase 2010

12. ITI Profiles (continued) • Health Record Sharing • Cross-Enterprise Document Sharing - b (XDS.b) ☼ • Cross-Enterprise Sharing of Scanned Documents (XDS-SD)☼ • Cross Community Access (XCA)☼ • Multi-Patient Queries (MPQ)☼ • Cross-Enterprise Document Media Exchange (XDM) ☼ • Cross-Enterprise Document Reliable Interchange (XDR) • Retrieve Information for Display (RID) • Workflow Enabler • Patient Synchronized Applications (PSA) • Notification of Document Availability (NAV) • Retrieve Form for Data Capture (RFD) ☼ • Document Metadata Subscription (DSUB) ☼ • Support Management • Consistent Time (CT) • Sharing Value Sets (SVS) ▀ colored text designates 2009 new profiles ☼ Designates profiles being demonstrated at HIMSS Interoperability Showcase 2010

13. Health Record Sharing - Document Sharing Document Content Profiles (examples) PreSurgery PPHP Consent BPPC Emergency EDR Scanned Doc XDS-SD Discharge &Referrals XDS-MS PHR Exchange XPHR Laboratory XD*-Lab Imaging XDS-I Document Exchange Profiles Document SharingXDS ReliableInterchange XDR MediaInterchange XDM Cross-Community AccessXCA ITI Profiles are shown with a red border

14. IHE IT Infrastructure Plan for 2010 • New Supplements For 2010 • Enhanced Sharing Value Set (Enhanced SVS) • Add supports for registering and updating value sets • Healthcare Provider Directory (HPD) • Supports healthcare provider search and feed • System Directory for Document Sharing (SDDS) • Supports directory of services used in document sharing environments • XDS Metadata Update Service • Supports update of metadata registered in a XDS Document Registry • Dynamic/Deferred Document Sharing (D3S) • Supports registration, query and retrieve of document content that is created at time of retrieval. • XUA Extension for Access Control • Extend XUA SAML assertion with authorization attributes

15. Analysis of ITI support efforts to date

16. Next Steps • Validate the domain-specific column of analysis worksheet and provide feedback on categories and completeness of content • Ascertain the extent of adoption of ITI profiles in your domain/region • Discuss how ITI liaison can be most effectively utilized to support your domain/region • Develop your domain/region’s strategic approach for ITI support • Short-term: Establish domain priorities to be proposed to ITI (target: July), in support of the domain’s preparation of profile proposals for submission to ITI’s 2010/2011 planning cycle (Sept)