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3 HITSP: Harmonizing standards to support the Nationwide Health Information Network 2006 – the First “Turn of the Crank” Consumer Empowerment – Medications – Allergies – Demographics – Advance Directives Electronic Health Records – Laboratory including blood banking and microbiology – Ordering and results exchange Biosurveillance – Deidentified registrations – Labs – Radiology text results
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Healthcare Information Standards Panel
2007,2008, and Beyond
John D. Halamka MD
Chair, HITSP
Agenda
HITSP Interoperability Specifications 2006, 2007, and 2008
Personal Health Records and the role of HITSP in defining them
HITSP's alignment with CCHITThe HITSP process for repurposing interoperability
specificationsThe Future of HITSP
3HITSP: Harmonizing standards to support the Nationwide Health Information Network
2006 – the First “Turn of the Crank”
Consumer Empowerment– Medications– Allergies– Demographics– Advance Directives
Electronic Health Records– Laboratory including blood banking and microbiology– Ordering and results exchange
Biosurveillance– Deidentified registrations– Labs– Radiology text results
4HITSP: Harmonizing standards to support the Nationwide Health Information Network
2006 – the Second “Turn of the Crank”
Privacy and Security standards
Emergency Responder
Personal Health Records
Medication Management
Quality
5HITSP: Harmonizing standards to support the Nationwide Health Information Network
Consumer Access to Clinical Information
6HITSP: Harmonizing standards to support the Nationwide Health Information Network
Medications Management
7HITSP: Harmonizing standards to support the Nationwide Health Information Network
Quality
8HITSP: Harmonizing standards to support the Nationwide Health Information Network
Security Standards
Collect and Communicate Security Audit Trails
Consistent Time
Document Integrity
Manage and Control Data Access
Manage and Control Privacy Consents
Manage Entity Identity Credentials
Non-Repudiation
Secure Communications Channel
User Authentication
9HITSP: Harmonizing standards to support the Nationwide Health Information Network
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
HITSP 2007 Timeline
02/05/07HITSP Board
04/23/07HITSP Board
07/09/07HITSP Board
10/09/07HITSP Board
03/19/07HITSP Panel
05/11/07HITSP Panel
09/07/07HITSP Panel
03/06 – 03/08TC Face to Face
Chicago IL
5/08 – 5/10TC Face to Face
Arlington VA
6/18 – 6/20TC Face to Face
San Diego CA
09/04 – 09/06TC Face to Face
Arlington VA
Requirements, Standards Selection, and Design
Public Input Inspect Test and Public Comment
Implementation Support and Testing
(with annual updates as required)
Comment Resolution and Panel Approval
01/19 – 04/1204/13 – 05/03
IS Construct Development
04/13 – 07/19 07/20 – 08/16 08/17 – 10/15
Implementation Support and Testing(includes minor document updates)
EHR, CE and BIO v 2.0
Activity 1 – Version 2.0 of Existing EHR, CE, BIO ISs
Activity 2 – On-going Work for Existing EHR, CE, BIO ISs (e.g. Security and Privacy) Activity 3 – New Emergency Responder EHR Use Case
On-going Support
10/15/07HITSP Panel
07/16/07HITSP Panel
02/12/07HITSP Panel
Activity 4 –New Use Cases from AHIC
Detail Schedule to be Established Upon Review of the Use Cases
Work Plan and Schedule Overview
S&P and EHR-ER v 1.0, EHR, CE, and BIO v M.m
10HITSP: Harmonizing standards to support the Nationwide Health Information Network
Overall Timeline2006 2008
Timeline (Calendar Year)2007 2009 2010
2006 Use Cases
· Consumer Empowerment
· EHR· Biosurviellance
HITSP RDSS & ConstructsRelease 1
HITSPRelease 2
Accepted by Sec.
CCHIT 2008 Certification
CCHIT 2008 Criteria Development
Recognized by Sec.
New Federal Systems and Upgrades
HITSPRelease 2
AHIC Medication Management, Quality
and Consumer Access to Clinical Information Use Cases Published New Federal Systems and Upgrades
NHIN Trial Implementations
2008Use Cases
· Referrals and Transfer of Care
· Remote Monitoring
· Remote Consultation
· Public Health Case Reporting
· Response Management
· Personalized Healthcare
AHIC Use Cases Published
Accepted by Sec. Recognized by Sec.
New Federal Systems and Upgrades
CCHIT 2010 Certification
CCHIT 2010 Criteria Development
HITSP RDSS and ConstructsRelease 1
HITSPRelease 2
CCHIT 2009 Certification
CCHIT 2009 Criteria Development
NHIN Trial Implementations
HITSP Medication
Management, Consumer
Access and Quality
RDSS and Constructs Release 1
Accepted by Sec.
Recognized by Sec.
2007Use Cases
· Emergency Responder EHR
· Medication Management
· Quality· Consumer
Access to Clinical Information
HITSPEmergency
Responder EHRRDSS and
Constructs r1
AHIC Emergency Responder EHR Use
Case Published
Accepted by Sec.
New Federal Systems and UpgradesHITSPRelease 2
Recognized by Sec.
2011AHIC Use Cases
11HITSP: Harmonizing standards to support the Nationwide Health Information Network
Personal Health Records
Numerous commercial, payer/employer and hospital-based products will become available in 2008 that will enable the patient to become stewards of their own data.
We should expect and look forward to recognition of PHR systems in the future, similar to CCHIT certification of EHR systems, based on the HL7 PHR system function model.
HITSP and HL7 should continue their close alignment and good working relationship on the development of standards related to consumer privacy and interoperability for the use of these systems.
The HITSP standard for medical summary exchange, CCD, will be a major factor in enabling patients to retrieve their data from hospitals and ambulatory care sites. The HITSP security standards will be important in enabling the patient to control and exchange this data among caregivers
12HITSP: Harmonizing standards to support the Nationwide Health Information Network
HITSP and CCHIT
Recent HITSP/CCHIT MOU regarding interoperability standards
CCHIT Interoperability Expert Panel will look first to HITSP-approved standards
If HITSP-approved standard not available/ready for a market need, CCHIT will request HITSP opinion on candidate standard as a “Roadmap standard” and level of readiness
If HITSP can not deliver timely response to above, CCHIT may look to directly to SDOs
Recognition and Certification timelines have been aligned
13HITSP: Harmonizing standards to support the Nationwide Health Information Network
Repurpose of HITSP Interoperability Specs and Constructs
Repurposing– New actor– New information interchange– New information content
A Technical Review Board, a proposed new appointed subgroup of the TC Leadership including project team, analyzes all new use cases and change requests and assigns to these to TCs for preliminary analysis and planning.
14HITSP: Harmonizing standards to support the Nationwide Health Information Network
The Future of HITSP
HITSP will be tightly aligned with the AHIC successor and is likely to obtain consistent funding from it.
HITSP has successfully brought together different camps of standards volunteers and has expanded the overall population of standards volunteers with each use case. We expect this expansion of the volunteer base to continue with the 2008 use cases The next set of use cases are proposed to harmonize standards in new territory such as remote medical device interoperability with EHRs, and remote clinical consultation.
15HITSP: Harmonizing standards to support the Nationwide Health Information Network
Summary
HITSP has become an established, trusted organization with a multi-stakeholder, open, transparent process for standards harmonization
In 2007, we will complete 4 additional use cases plus security/privacy
In 2008, we expect an additional 3-4 use cases
In 2009, we will align with the AHIC Successor and continue to serve stakeholders nationwide
