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Nationwide Healthcare Information Network Design Decisions and Lessons Learned

Nationwide Healthcare Information Network Design Decisions and Lessons Learned. Dave “Casey” Webster IBM NHIN Chief Architect. September 11, 2006. Community-Centric First build communities, then connect them Communities determine where data is stored (centralized, locally, or both)

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Nationwide Healthcare Information Network Design Decisions and Lessons Learned

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  1. Nationwide Healthcare Information NetworkDesign Decisions and Lessons Learned Dave “Casey” Webster IBM NHIN Chief Architect September 11, 2006

  2. Community-Centric First build communities, then connect them Communities determine where data is stored (centralized, locally, or both) Lightweight, secure community hub provides basic services Drive and conform to standards Instantiation of IHE interoperability framework using Java/J2EE (www.ihe.net) Clinical events stored as HL7 CDA(r2)-compliant documents Provide security & privacy w/o sacrificing usability or research value Anonymous/pseudonymous data that can be re-identified as needed/permitted Support other data aggregates (registries, outcomes analysis, quality of care) Practical Scalable and cost-effective at every level of practice Point-of-care performance is critical to adoption IBM NHIN Architecture Design Decisions HL7 Plenary Session – Boca Raton – September 11, 2006

  3. Community Hub Document Locator Support Services Patient Identification ATNA (Audit) URIs PIX (ID Xref) Registry Services CT (Clock) PDQ (Demog) Logging Access Control NHIN Interface Community Services Cross-Community: • Search/Retrieval • Policies/Security • Admin/Maintenance Biosurveillance Authentication XDS PHR Portal Authorization Community XDS Patient Consent Data Services Document Services Data Gateway Integration Engine or Data Source Document Storage and Retrieval XDS Patient Lookup CDA Transform IBM NHIN Architecture Network Security Hospital or Physician Practice Interface HL7 Plenary Session – Boca Raton – September 11, 2006

  4. Community Hub Document Locator MPI Services URLs Security Services Registry Services ‚ „  … ƒ † µ Find Document (intracommunity) Action Sequence PIX PDQ Document Services Document Storage and Retrieval XDS (CDA) HL7 Plenary Session – Boca Raton – September 11, 2006

  5. Technology isn’t a significant barrier Consumer readiness, politics, lack of universal standards are much more problematic Politics can drive architecture Substantial complexity and cost necessary to work around issues such as patient identification, provider authorization, state and local healthcare and privacy differences, etc. It is difficult to effectively separate policy from functionality Lessons Learned HL7 Plenary Session – Boca Raton – September 11, 2006

  6. Thank you!

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