establishing trusted exchange among unaffiliated organizations

Establishing Trusted ExchangeAmong Unaffiliated Organizations

A Replay of the Western States Consortium Demonstration at the HIMSS Interoperability Showcase

20 March 2013

Today’s Players

In order of appearance…

• Robert Cothren, PhDTechnical Director, CHeQ Program, UC Davis Health System

• Chris JiorasProject Manager, North Coast Health Information Network

• Sharon Wentz, RNBusiness Development Coordinator, CareAccord™

• Jane McCordInformation Services Liaison, North Coast Health Information Network

• Will RossProject Manager, Redwood MedNet

1

Western States Consortium

Investigating the policies, procedures, and technologies that allow and promote interstate exchange of health information.

Use case…

Using Directto exchange clinical information

between providersacross state lines

for treatment purposes.

2

Scalable Trust

Use case…• Exchange between providers across state lines for treatment purposes

…is really…• An example of exchange between unaffiliated organizations.

Really about scalable trust.

Two important components…

1. Establishing inter-organizational trust.2. Discovering how to communicate with others.

3

What you will see…

4

What you will see…

5

6

Start the demo…

7

Sidebar…

Regional HISP Regional HISP

Regional HISP

Distributed Directory Search

1. CareAccord user requests address from CA.2. CA determines where to send query.3. CA forwards query to regional directories.4. Regional directories search and respond.5. CA consolidates responses.6. CA responds to CareAccord user.

CA State Directory OR State Directory

State HISP

AK State Directory

State HISP

Architecture:

• States query each other as peers

In CA:

• Use federated directories

• Rules govern queries

?A

?

A

?

A

8

Regional HISP Regional HISP

Regional HISP

In CA:

• Use federated directories

• Rules govern queries

Distributed Directory Search

1. NCHIN user requests address from OR/WSC.2. CA determines where to send queries.3. CA forwards query to state directories.4. State directories search and respond.5. CA consolidates responses.6. CA responds to NCHIN user.

CA State Directory OR State Directory

State HISP

AK State Directory

State HISP

Architecture:

• States query each other as peers

A?

A

?

?

9

Regional HISP Regional HISP

Regional HISP

In CA:

• Use federated directories

• Rules govern queries

Distributed Directory Search

1. NCHIN user requests address from CA.2. CA determines where to send queries.3. CA forwards query to regional directories.4. Regional directories search and respond.5. CA consolidates responses.6. CA responds to NCHIN user.

CA State Directory OR State Directory

State HISP

AK State Directory

State HISP

Architecture:

• States query each other as peers

A

?

??

AA

10

11

Back to the demo…

12

Sidebar…

Scalable Trust

• Trust Community: a group of organizations that elect to adopt a common set of policies and processes in regard to health information exchange.

• Trust Bundles: the collection of trust anchors for members of a Trust Community.

See http://bundles.hiecosystem.net/wsc/

13

Moving from today’s world of point-to-point trust agreements…

… to tomorrow’s world of scalable trust.

Trust Bundles

14

Back to the demo…

15

Questions…