HIT Policy CommitteeHIT Policy CommitteeNHIN WorkgroupNHIN WorkgroupIntroductory RemarksIntroductory Remarks

David Lansky, ChairDavid Lansky, ChairPacific Business Group on Health

Danny Weitzner, Co-ChairDanny Weitzner, Co-ChairDepartment of Commerce, NTIA

December 15, 2009

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Workgroup Members

Chair David Lansky, Pacific Business Group on Health

Co-Chair Danny Weitzner, Department of Commerce, NTIA

Members• Christine Bechtel, National Partnership for Women & Families• A. John Blair, III, Taconic IPA• Neil Calman, Institute for Family Health• James Borland, Social Security Administration• Carol Diamond, Markle Foundation• Colin Evans, Dossia• Tim Cromwell, Department of Veterans Affairs• Jonah Frohlich, Deputy Secretary, Health IT, California• Leslie Harris, Center for Democracy and Technology• Arien Malec, Relay Health• Marc Overhage, Regenstrief Institute• Marc Probst, Intermountain Healthcare• Wes Rishel, Gartner• Micky Tripathi, Massachusetts eHealth Collaborative

ONC Farzad Mostashari Todd Park Doug Fridsma

NHIN Workgroup Charge

To create a set of recommendations for a policy and

technical framework that allows the internet to be used

for the secure and standards-based exchange of health

information in a way that is both open to all and fosters

innovation.

The Workgroup will provide an initial set of recommendations

to the HIT Policy Committee in January.

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Priority Focus Areas - Rationale

• Draft meaningful use criteria for 2011 implicates health information exchange among providers and with patients.

• A foundational element to achieve several of the criteria will be “push” of patient data from one provider to another, or from one organization to another (e.g., doctor to consultant, or lab to doctor, or doctor to pharmacy), where the sender may not have a prior relationship with the recipient.

Foundational NHIN Components

• Vocabulary Standards• Document / Message Standards• Directories and certificates• Delivery protocols• Authentication• Security and trust relationship

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Priority Focus Area - Directories

• In examining the “push” function, the workgroup focused on the need for standardized, accessible directories that allow the sender to reliably locate the recipient – even the off-line recipient.

• The workgroup will host a public hearing on current approaches to directories on December 16.

• A second hearing, on authentication issues, is planned for January 7.

HIT Policy CommitteeHIT Policy CommitteeNHIN WorkgroupNHIN WorkgroupThe ContextThe Context

Remarks by Dr. Farzad Mostashari

Outline

• Context • NHIN today• NHIN tomorrow• Use cases• Key Considerations

Section 3001(b)

ONC is to foster “a nationwide health information

technology infrastructure that allows for the electronic

use and exchange of information and that…promotes 

a more effective marketplace, greater competition…

[and] increased consumer choice” among other goals.

Exchanging Patient Data

Vocabulary/ Document/ Message StandardsVocabulary/ Document/ Message Standards DirectoriesDirectories

AuthenticationAuthenticationDelivery ProtocolsDelivery Protocols

SecuritySecurity

Trust RelationshipsTrust Relationships

Vocabulary StandardsVocabulary Standards

Document/Message StandardsDocument/Message Standards

Delivery ProtocolsDelivery Protocols

Security and Trust relationshipsSecurity and Trust relationships

Directories and CertificatesDirectories and Certificates

Exchanging Patient Data

NHIN: supporting meaningful use in 2011 & 2012

Provider Provider

ProviderPharmacy

Lab Provider

Meet the needs of today and tomorrow

2011 - ePrescribing - Lab results into EHRs - Exchange key clinical information - Public health reporting

2013 - Patient PHR access

- ePrescribing refills - Summary record - transition of care - Receive health alerts - Immunization information

2015- Access comprehensive patient data

- Automated real-time surveillance

Goal: This is part of an evolutionary pathThere will be incremental growthAll journeys start with a few steps

Key Considerations

• Reinforce a solid trust fabric• How to achieve authentication (January 7, 2010 hearings)

• Identify what can be done today to accelerate use of information exchange

• Clarify role of government• Enable broad participation across broad spectrum of

organizations, large and small

Agenda for December 16 hearing

• 10:05 a.m. Level Setting & Review of Objectives

• 10:20 a.m. Summary of Approaches for NHIN Meaningful Use

in 2011 & Components of the NHIN

• 10:40 a.m. Testimony - SureScripts

• 11:00 a.m. Testimony - Council for Affordable Quality Healthcare

• 11.20 p.m. Testimony - Emdeon

• 11.40 p.m. Testimony - Social Security Administration

• 12:00 p.m. Testimony - Federation of State Medical Boards

• 12:20 p.m. Public Comments

• 12:50 p.m. Summary and Closing

• 1:00 p.m. PUBLIC MEETING ADJOURNS