Sandbox+2

 Nationwide Health Information Network Exchange Standards and Interoperability Specifications – Wiki Home Page =  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 Network] is 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 [|ONC] s 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 N ationwide 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 goal of the Spec Factory is to: · 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:  o Standards  o Services  o 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
o To be notified about significant events and announcements from the Spec Factory, follow the Spec Factory blog. o Join in community discussion in the nationwide health information network Exchange Discussion group. o If you'd like to stay actively involved, subscribe to an RSS feed or use the "Notify Me" tab to stay on top of updates to the wiki pages that interest you.

How do I Join?
 o To join the wiki simply create a Wikispaces account and request membership to the NATIONWIDE HEALTH INFORMATION NETWORK Exchange Standards and Interoperability Specifications wiki  o View the individual workgroup sites and decide which workgroup you wish to join  o To join a particular domain group, send email request to xxxx@nih.gov  o Refrain from defacement, abuse, commercial promotion, or other content that violates our __ guidelines for community participation __

 Guidelines for Participation - Page

Paths To Participation
** Health Domain Workgroup  ** A __ Health Domain Workgroup __ of public-private stakeholders are developing specifications to address information exchanges required for workflows associated with specific healthcare domains, such as clinical care, public health, pharmacy and others through an open process allowing for a wide set of participants to provide input, feedback, code development etc.

Members of the Health Domain Workgroup must pledge to participate as Active Participants via formal meetings and commit to active involvement. Individuals or organizations who want to participate in the Health Domain Workgroup and believe they can meet these requirements should issue their commitment in our [|commitment tracker] and send email to xxx@nih.gov.

** Infrastructure Workgroup  ** An __ Infrastructure Workgroup __ of public-private stakeholders are developing specifications to address specifications that are not specific to individual healthcare domains; examples include messaging platform, security, and information exchange services through an open process allowing for a wide set of participants to provide input, feedback, code development etc.

Members of the Infrastructure Workgroup must pledge to participate as Active Participants via formal meetings and commit to active involvement. Individuals or organizations who want to participate in the Infrastructure Workgroup and believe they can meet these requirements should issue their commitment in our __ commitment tracker __ and send email to xxx@nih.gov.

** Observers  ** Observers are a subset of the expanded group who wish to actively participate by attending Workgroup meetings, but cannot make an active commitment. Observers may not vote in the consensus process, but are welcome to participate in teleconferences and may participate in the Face to Face meetings as space is available on a first-come, first-served basis.

** Using the Wiki  ** Each Workgroup has its own Wiki page, allowing for the community to work together on a particular interoperability specification. The discussions behind each interoperability specification should be vigorous - building a common understanding of what each specification means, and its implication for health data exchange. Be kind to our mistakes; if you notice inconsistencies or areas left undone, note them, or if you have edit privileges, help fix them, in a manner as community-minded as possible. Anyone out there with design skills that wants to help spruce up the wiki or the blog is welcome to volunteer as well.

Rules for Using the Wiki
Keeping any Wiki community focused and productively engaged requires all of us to follow some simple rules of etiquette, rules that apply to how we participate in discussions and edit each others' pages.

Those rules include: While there is much that could be written as to how a community might moderate itself, the most important guideline for any participant is still the Golden Rule: treat others the same way you yourself would like to be treated. Perhaps more cribbed from the Wikipedia " [|Etiquette] " page?
 * No posting of off-topic content or links.
 * No deleting the work of others without community discussion.
 * No getting too "personal" towards other contributors in your comments or using profanity.
 * No misrepresenting your own identity or other information in your profile.
 * No engaging in "Wiki wars" where two parties reverse each others' edits without striving for a neutral point of view or creating separate pages.

 Team Page

Health Domain Workgroup:
The goal of the Health Domain Workgroup is to: Develop specifications to address information exchanges required for workflows associated with specific healthcare domains, such as clinical care, public health, pharmacy and others This workgroup will have the following domains: ** __Continuity of care between providers__ ** which includes meaningful use provisions associated with:  · Summary of care for each transition of care and referral  · Capability to exchange key clinical information (coordination)  · Retrieval of lab results ** __Consumer Empowerment__ **, which includes meaningful use provisions associated with:  · Provide patients a copy of their electronic health information  · Timely electronic access/ clinical summaries for each visit ** __Pharmacy__ ** information exchanges, which includes meaningful use provisions associated with: <span style="margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l9 level1 lfo8; text-indent: -0.25in;"> · E-prescribing <span style="margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l9 level1 lfo8; text-indent: -0.25in;"> · Medication history ** __Public Health__ **, which includes meaningful use provisions associated with: <span style="margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l10 level1 lfo9; text-indent: -0.25in;"> · Submit data to immunization registries <span style="margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l10 level1 lfo9; text-indent: -0.25in;"> · Submit reportable lab results to public health agencies <span style="margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l10 level1 lfo9; text-indent: -0.25in;"> · Provide electronic syndrome surveillance ** __Quality Reporting__ **, which includes meaningful use provisions associated with: <span style="margin: 0in 0in 0pt 1.25in; mso-add-space: auto; mso-list: l0 level1 lfo10; text-indent: -0.25in;"> · Submit quality reports ** __Healthcare Claims and Administration__ **, which would focus on CMS requirements to implement X12-based administrative transactions over the NATIONWIDE HEALTH INFORMATION NETWORK, as described above in section 5.1.

Infrastructure Workgroup:
The Infrastructure Group will address needs that apply across multiple health domains. This group supports the MU provisions through ensuring adequate security and privacy protections within the NATIONWIDE HEALTH INFORMATION NETWORK, addressing inferred infrastructure requirements described previously and facilitating better coordination of care across health domains. Specific focus areas include: ** Location services **, which would include: <span style="margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l0 level1 lfo10; text-indent: -0.25in;"> · Provider location services <span style="margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l0 level1 lfo10; text-indent: -0.25in;"> · Current NHIE service registry <span style="margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l0 level1 lfo10; text-indent: -0.25in;"> · Patient discovery services ** Document exchange **, which includes: · Document query and retrieval · Document submission · Document publish and subscribe ** Messaging Infrastructure **, which may include derived requirements: · Message addressing and routing ** Security and Privacy **, which includes meaningful use provisions associated with: <span style="margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l1 level1 lfo12; text-indent: -0.25in;"> · Adequate security and privacy <span style="margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l1 level1 lfo12; text-indent: -0.25in;"> · Best practices and vulnerabilities

Spec Factory Team:
The overall Specifications Factory team would meet regularly to focus on the following specifications development responsibilities: <span style="line-height: normal; margin: 0in 0in 0pt 1in; mso-list: l2 level1 lfo2; text-indent: -0.25in;"> · Coordination of activities across the Health Domain and Infrastructure workgroups <span style="line-height: normal; margin: 0in 0in 0pt 1in; mso-list: l2 level1 lfo2; text-indent: -0.25in;"> · Address issues associated with the specifications by implementers <span style="line-height: normal; margin: 0in 0in 0pt 1in; mso-list: l2 level1 lfo2; text-indent: -0.25in;"> · Coordinate specifications development with other ONC OIS Standards and Interoperability Framework initiatives <span style="line-height: normal; margin: 0in 0in 0pt 1in; mso-list: l2 level1 lfo2; text-indent: -0.25in;"> · Assign incoming work to the Health Domain and Infrastructure workgroups <span style="line-height: normal; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l2 level1 lfo2; text-indent: -0.25in;"> · Review specifications developed by the Health Domain and Infrastructure workgroups