S&I+Home

= What is the S&I Framework? = The HITECH Act authorizes the Centers for Medicare & Medicaid Services (CMS) to administer incentives to eligible professionals (EPs) and hospitals for meaningful use of certified electronic health records (EHRs). These incentives are anticipated to drive adoption of EHRs needed to reach the goal of all Americans having secure EHRs by 2014. A key component of “meaningful use” is certified electronic health records and key certification criteria are that the electronic health record is interoperable and adheres to standards adopted by the Secretary. The Office of the National Coordinator for Health Information Technology (ONC) has developed an interoperability and standards framework that has several key steps and the Nationwide Health Information Networkis a critical component of the framework. The overview of the framework is provided in Figure 1 below. Figure 1: S&I Framework Each task within the S&I framework will fit into the ONCs Standards and interoperability framework. This framework is also a life cycle for the development of standards and interoperability specifications and is meant to establish a sustainable set of tools and processes that will streamline and coordinate the development of standards and interoperable software solutions to support the goals of the HITECH Act. The standards and interoperability framework will support all ONC programs and effort in increasing adoption of health IT across the entire health care enterprise.

What is the Nationwide Health Information Network?
The Nationwide Health Information Network is a set of standards, services and policies that enable secure health information exchange over the Internet. The network will provide a foundation for the exchange of health information across diverse entities, within communities and across the country, helping to achieve the goals of the HITECH Act. This critical part of the national health IT agenda will enable health information to follow the consumer, be available for clinical decision making, and support appropriate use of healthcare information beyond direct patient care so as to improve population health.

What is the Nationwide Health Information Network Interoperability Specifications Factory?
The HITECH Act highlights the need for standards and interoperability specifications to support health information exchange. The role of the Spec Factory is to develop interoperability specifications based upon use cases that could be used to test the Nationwide Health Information Network.

**The goals of the Spec Factory are as follows:**

 * Using model centric approach, develop a Platform Independent Model (PIM) that will serve as the basis for the nationwide health information network specifications
 * Leverage the National Information Exchange Model (NIEM) process and package specifications into NIEM Information Exchange Package Documentation (IEPD) building upon the current specifications visions for the nationwide health information network, adhering to applicable governing body decisions and prioritizations to support use cases, business scenarios and implementations.
 * Generate Implementation Specification with an explicit description of the __standards__, __services__ and __policies__.
 * Create guidelines for development of reference implementation

Development of interoperability specifications is a critical step in the process. The overall effort of the Spec Factory will include development of interoperability specifications that are independent of specific software architecture (a platform-independent model, or PIM). Federal agencies that have different software requirements (such as CMS) can use the PIM to develop interoperable models and/or software specific to nationwide health information network (PSM specifications) that can exchange data in the nationwide health information network. States, companies, or nationwide health information network partners can use the PSM to develop new data models and/or applications that conform to the nationwide health information network interoperability specification. Focus on PIM specifications will foster innovations in the marketplace as well as support federal agencies and nationwide health information network partners in their effort.

What is NIEM?
The National Information Exchange Model (NIEM) is designed to develop, disseminate, and support enterprise-wide information exchange processes and standards that can enable jurisdictions to effectively share critical information in both emergency and routine situations. NIEM provides a common vocabulary with terms, definitions, and formats - independent of an individual agency’s database management systems; and a structured approach to developing the reference documentation that expresses the NIEM information exchange’s requirements in an implementation ready format – the Information Exchange Package Documentation (IEPD) development process. ONC would like to leverage many of the tools and resources from the NIEM. Today the NIEM does not include a healthcare domain. Therefore, ONC will develop and support healthcare specific tools to meet the unique needs of the healthcare communities and the privacy and security concerns of health care consumers. However, NIEM provides a consistent approach that will help develop consistent description of use cases and help the healthcare stakeholders. Also, leveraging the tools and resources available in the NIEM process will help each new case to build on previous use cases.

Who is the Spec Factory Team?
The Spec Factory is made up stakeholder members who come from across the healthcare IT industry. Figure 2 below, provides an overview of the composition of the Spec Factory team and workgroups. Figure 2: Nationwide Health Information Network Exchange Specifications Factory Structure

How do I Get Involved?
The Spec Factory is open to all individuals and Organizations who wish to make contributions in defining Interoperability Specifications that could be used to test the Nationwide Health Information Network The individual Spec Factory workgroups listed above have regular meetings throughout the year. You can participate as a Workgroup Leader, an Active Participant or an Observer. **Keep me informed**
 * To be notified about significant events and announcements from the Spec Factory, follow the Spec Factory blog.
 * Join in community discussion in the nationwide health information network Exchange Discussion group.
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**How do I join?**
 * To join the wiki simply create a Wikispaces account and request membership to the Nationwide Health Information Network Exchange Standards and Interoperability Specifications wiki
 * View the individual workgroup sites and decide which workgroup you wish to join

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