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Dixie Baker, Chair Walter Suarez, Co-Chair May 18, 2011

HIT Standards Committee Privacy and Security Workgroup Recommendations for Electronic Health Record (EHR) Query of Provider Directories. Dixie Baker, Chair Walter Suarez, Co-Chair May 18, 2011. Privacy and Security Workgroup. Dixie Baker, SAIC John Blair, Taconic

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Dixie Baker, Chair Walter Suarez, Co-Chair May 18, 2011

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  1. HIT Standards CommitteePrivacy and Security WorkgroupRecommendations for Electronic Health Record (EHR) Query of Provider Directories Dixie Baker, Chair Walter Suarez, Co-Chair May 18, 2011

  2. Privacy and Security Workgroup Dixie Baker, SAIC John Blair, Taconic Anne Castro, BlueCross BlueShield of South Carolina Aneesh Chopra, Federal Chief Technology Officer Mike Davis, Veterans Health Administration Lisa Gallagher, HIMSS Ed Larsen David McCallie, Cerner Corporation John Moehrke, General Electric Steve Findlay, Consumers Union Jeff Jonas, IBM Wes Rishel, Gartner Walter Suarez, Kaiser Permanente Sharon Terry, Genetic Alliance

  3. Needs Identified by HIT Policy Committee • Identified need for consistent approach to cross-organizational provider directories to support the exchange of health information • September 2010 Testimony resulted in narrowing of focus to: • Interoperability among existing directories (no “rip and replace”) • Interoperability between EHRs and provider directories: Capability for EHR’s to query national (federated) enterprise-level provider directory • Central need: Capability to search for and find “discoverable” information essential for enabling exchange of health information between enterprises • Enterprise-level provider directory (ELPD) content should be limited to: • Basic entity information (e.g., name, address, human point-of-contact) • Externally accessible information exchange services (e.g., domains, message protocols, transport protocols, “inbox” locations) • Security credentials 3

  4. Two-Phased Approach for Developing Recommendations for Provider Directory Standards • To meet immediate need for standards to support Stage 2 EHR certification, recommend standards, implementation specifications, and certification criteria for EHR query of enterprise-level provider directories • Recommendations presented today • Develop recommendations for Enterprise-Level and Individual-Level Provider Directories in concert to address needs identified by the HIT Policy Committee • Recommendations for Enterprise-Level Provider Directories received in February 2011 • HITPC approved Information Exchange Workgroup’s recommendations for Individual-Level Provider Directories May 11, 2011

  5. Standards Requirements INITIAL PRIORITY ELPD National Registry System ELPD ELPD Registrar Certification Criteria for EHRs to Support ELPD Messages (policy needs) ELPD Registrar Certification; ELPD Certification; Guidelines for Verification/ Validation; Registrar Reciprocity Standards for Query/Response Messages Standard for ELPD Submission to National Registry Standard for ELPD Structure and Content

  6. Public Testimony Received to Date by the P&S WG • NwHIN requirements for directory services • Direct Project • Exchange • Veterans Health Administration • HIEs • Department of Vermont Health Access • New England Healthcare Exchange Network (NEHEN) • Standards • Integrating the Healthcare Enterprise (IHE) Healthcare Provider Directory (HPD) Profile and Social Security Administration (SSA) experience with IHE HPD • ASC X12 Provider Directory transaction • HL7/OMG’s collaborative effort on the Healthcare and Community Services Provider Directory (HCSPD)

  7. Scope of Current Recommendation • Standards, implementation specifications, and certification criteria to support Stage 2 meaningful-use of EHRs to query enterprise-level provider directories • Standards and implementation specifications needed: • Schema • Vocabulary • Transport • Query Language • Certification functionality needed: • Search for and discover entity (i.e., search => list => select) • Search for and discover services entity offers for exchanging information with other entities (including entity’s URL or electronic address to receive information) • Search for and discover entity’s security credential 7

  8. Current NwHIN Standards 1 While the LDAP family of standards does not explicitly address identity federation, multiple strategies exist for federating LDAP directories. Because DNS is inherently federated, the Direct Project chose to use it for credential discovery, while recognizing that an LDAP approach would be a more complete solution.

  9. Schema, Content, Transport, and Query Standards

  10. Functionality Supported 1 Individual-Level Provider Directories are outside the scope of the current task, but need to be anticipated

  11. Recommended Standards, Implementation Specifications, and Certification Criteria 1 The Standards and Interoperability Framework team should select either REST or SOAP, as most appropriate within the context of the NwHIN standards currently being defined. 2 To support LDAP federation, a profile specifying a standardized way to federate LDAP directories is needed. 11

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