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Advancing Health IT




Standards Update & Federal Health
Architecture Overview

Lauren Thompson, PhD
Director, Federal Health Architecture
Agenda


1. Standards Update
  โ€ข Structured Data Capture Initiative


2. Federal Health Architecture
  โ€ข Program Overview
  โ€ข Vision & Goals for 2013




                                         2
Standards Update: Structured Data Capture
      (SDC) Initiative

Focus: Solve a specific interoperability challenge through the
development of four new standards that will enable EHRs to
capture and store structured data.
โ€ข   Standards for the CDEs that will be used to fill the specified forms or
    templates
โ€ข   Standards for the structure or design of the form or template
    (container)
โ€ข   Standards for how EHRs interact with the form or template
โ€ข   Standards to auto-populate form or template


Goal: Address this challenge in terms of the structured data
requirements needed in Research and Patient-Safety Event
Reporting


                                                                              3
Standards Update: DRAFT SDC Charter Scope
      Statement

Define the necessary requirements which will drive the
identification and harmonization of standards that will facilitate the
collection of supplemental EHR derived data

Develop and validate a standards based data architecture so that
a structured set of data can be accessed from EHRs and be
stored for merger with comparable data for other relevant
purposes to include:
โ€ข   The electronic Case Report Form (eCRF) used for clinical research
    including Patient-Centered Outcomes Research (PCOR)
โ€ข   The Incident Report used for patient safety reporting leveraging
    AHRQ โ€žCommon Formatsโ€Ÿ
โ€ข   The Surveillance Case Report Form used for public health reporting
    of infectious diseases


                                                                         4
Standards Update: SDC Development


Charter: Draft is available for S&I community review on the wiki at
http://wiki.siframework.org/Structured+Data+Capture+Initiative

ONC Contacts:
โ€ข   Doug Fridsma (doug.fridsma@hhs.gov)
โ€ข   Farrah Darbouze (farrah.darbouze@hhs.gov)




                                                                      5
Federal Health Architecture

PROGRAM OVERVIEW
VISION & GOALS FOR 2013

                              6
Federal Health Architecture:
      Advancing National Health IT

Federal Health Architecture (FHA) program was
established as an OMB E-Gov Line of Business
(LoB)
โ€ข To support federal activities related to the development
  and adoption of health IT standards
โ€ข To ensure that agencies seamlessly and securely
  exchange health data with other agencies, other
  government entities, and with other public and private
  organizations


Over time, FHAโ€™s focus and scope has expanded
โ€ข To emphasize federal advancement of the national
  agenda for health IT
โ€ข To provide enterprise architecture, standards adoption,
  tools and communication support
                                                             7
FHA Participation
 FHA is working to engage the following agencies and other federal entities
 in initiatives such as the Nationwide Health Information Network, the Direct
                     Project, EHR adoption and CONNECT
โ€ข E-gov initiative managed by ONC within HHS   โ€ข Many federal agencies participate




                                                                                     8
Federal Health Architecture:
        Advancing National Health IT
                        FHAโ€™s Early Years

2003    to
                          โ€ข


                          โ€ข
                              July 2003 โ€“ OMB established FHA with HHS as the
                              Managing Partner
                              March 2004 โ€“ FHA designated by OMB as an e-gov


2008
                              initiative and a Line of Business initiative within the
                              Federal Enterprise Architecture
                          โ€ข   In 2006, FHA was moved organizationally within HHS
                              from the Office of the Chief Information Office to ONC


Key Initiatives
 โ€ข   Federal Health Enterprise Architecture
 โ€ข   Consolidated Health Informatics (standards)
 โ€ข   Standards Education and Coordination
 โ€ข   Federal Health Information Planning and Reporting/Investment Planning

                                                                                        9
Federal Health Architecture:
       Advancing National Health IT
                      FHAโ€™s Evolution

2009   to
                         โ€ข

                         โ€ข
                             2009 โ€“ ARRA/HITECH

                             2010 โ€“ Patient Protection and Affordable Care Act (ACA)

                         โ€ข   2010 โ€“ Federal CIOโ€Ÿs โ€œ25 Point Implementation Plan to

2011                     โ€ข
                             Reform Federal Information Technology Managementโ€

                             2010 โ€“ Presidentโ€Ÿs Council of Advisors on Science and
                             Technology (PCAST) โ€œReport to the President: Realizing
                             the Full Potential of Health Information Technology to
                             Improve Healthcare for Americans: the Path Forwardโ€


Key Initiatives
 โ€ข   Nationwide Health Information Network (NwHIN) Exchange
 โ€ข   CONNECT


                                                                                       10
Federal Health Architecture:
      Advancing National Health IT
FHA in 2012: Strategy and Architecture
      New Governance
       โ€ข More strategic alignment within and across Federal partner agencies
       โ€ข Greater transparency and enhanced communications
       โ€ข Commitment to fulfilling original intent of FHA as E-Gov Line of Business

      Strategy Planning
      โ€ข FHA Strategic Plan nearing completion
      โ€ข FHA Line of Business (LoB) Service Plan delivered to OMB

      Interoperability Architecture
       โ€ข Identify current and planned data exchanges among Federal agencies and
          partners
       โ€ข Develop FHA public-facing portal
       โ€ข Align with standards harmonization efforts (e.g. Standards and Interoperability
          Framework)
       โ€ข Demonstrate exchange methods beyond Direct and SOA โ€“ RHEx pilots

                                                                                           11
Federal Health Architecture:
      Advancing National Health IT
FHA in 2012: Innovations

  RESTful Health Exchange (RHEx)
    โ€ข An open source project, sponsored by FHA
    โ€ข Demonstrated simple, secure, standards-based Web technologies
      for health information exchange


  Two Pilots
    โ€ข Telemedicine & Advanced Technology Research Center (TATRC)
        โ€ข   Use Case: Consult/Referral
        โ€ข   Secure Person to Person exchange
        โ€ข   OpenID Connect for distributed user authentication
    โ€ข HealthInfoNet
        โ€ข   Use Case: Populate clinical data repository with patient data from HER at small health care
            provider in medically underserved area to Maine HIE
        โ€ข   Secure Machine to Machine exchange
        โ€ข   OAuth2 for service to service authentication

                                                                                                          12
Federal Health Architecture:
      Advancing National Health IT
FHA in 2012: Innovations

  CONNECT open source
    โ€ข CONNECT code on GitHub, sprint sessions open
    โ€ข Engaging open source community through code-a-thons, encouraging code
      contributions
    โ€ข Developing CONNECT 4.0, incorporating Direct specifications




                                                                              13
Partnership with eHealth Exchange

NwHIN Exchange is now eHealth Exchange
 โ€ข   Transitioned from ONC federal program to a public/private collaboration
 โ€ข   Healtheway, a non-profit, is supporting eHealth Exchange operations
      โ€ข   Testing and onboarding
      โ€ข   Maintaining DURSA, and operating policies and procedures
      โ€ข   Service registry and digital certificates
 โ€ข   CONNECT is a gateway to eHealth Exchange




                                                                               14
FHA Strategic Plan โ€“ Vision
 A Federal health information technology environment that is interoperable with the private
sector and supports the Presidentโ€Ÿs health information technology plan enabling better care,
                    increased efficiency, and improved population health




                                                                                               15
Federal Health Architecture:                               FHA Guiding
          Advancing National Health IT                                Principles


FHA Moving Forward: 2013 and Beyond                               Stakeholder
                                                                  Engagement
STRATEGIC GOALS

Establish a unified Federal voice on health data
exchange and interoperability                                     Demonstrate
                                                                  through Pilots
โ€ข   Establish FHA as a โ€œconvener of statureโ€, and broaden
    participation
โ€ข   Expand outreach and access to tools
                                                                  Open Communication
Achieve adoption of interoperability specifications, leading      and Transparency
to active data exchange in the Federal health community
โ€ข   Support S&I Framework by providing Federal use cases
                                                                  Commitment
    and pilots
                                                                  to Action
โ€ข   Enable FHA partners to move from legacy to new solutions in
    effective, coordinated manner

Align Federal policies in healthcare data exchange
                                                                  Focus on
                                                                  Specifications
โ€ข   Provide a forum of cataloging and aligning Federal policies
    and practices

                                                                                   16
Comments/Questions?




    Comments/Questions?




                          17
Stay connected, communicate and collaborate

โ€ข Find out more about FHA on the ONC website:
  http://www.healthit.gov/
โ€ข Contact us at: federal.health@hhs.gov
โ€ข Subscribe, watch, and share:


         @ONC_FHA,
         @CONNECT_Project

         Federal Health Architecture

         http://www.flickr.com/photos/federalhealtharchitecture/




                                                                   18

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Federal Health Architecture HIT Policy Committee Update

  • 1. Advancing Health IT Standards Update & Federal Health Architecture Overview Lauren Thompson, PhD Director, Federal Health Architecture
  • 2. Agenda 1. Standards Update โ€ข Structured Data Capture Initiative 2. Federal Health Architecture โ€ข Program Overview โ€ข Vision & Goals for 2013 2
  • 3. Standards Update: Structured Data Capture (SDC) Initiative Focus: Solve a specific interoperability challenge through the development of four new standards that will enable EHRs to capture and store structured data. โ€ข Standards for the CDEs that will be used to fill the specified forms or templates โ€ข Standards for the structure or design of the form or template (container) โ€ข Standards for how EHRs interact with the form or template โ€ข Standards to auto-populate form or template Goal: Address this challenge in terms of the structured data requirements needed in Research and Patient-Safety Event Reporting 3
  • 4. Standards Update: DRAFT SDC Charter Scope Statement Define the necessary requirements which will drive the identification and harmonization of standards that will facilitate the collection of supplemental EHR derived data Develop and validate a standards based data architecture so that a structured set of data can be accessed from EHRs and be stored for merger with comparable data for other relevant purposes to include: โ€ข The electronic Case Report Form (eCRF) used for clinical research including Patient-Centered Outcomes Research (PCOR) โ€ข The Incident Report used for patient safety reporting leveraging AHRQ โ€žCommon Formatsโ€Ÿ โ€ข The Surveillance Case Report Form used for public health reporting of infectious diseases 4
  • 5. Standards Update: SDC Development Charter: Draft is available for S&I community review on the wiki at http://wiki.siframework.org/Structured+Data+Capture+Initiative ONC Contacts: โ€ข Doug Fridsma (doug.fridsma@hhs.gov) โ€ข Farrah Darbouze (farrah.darbouze@hhs.gov) 5
  • 6. Federal Health Architecture PROGRAM OVERVIEW VISION & GOALS FOR 2013 6
  • 7. Federal Health Architecture: Advancing National Health IT Federal Health Architecture (FHA) program was established as an OMB E-Gov Line of Business (LoB) โ€ข To support federal activities related to the development and adoption of health IT standards โ€ข To ensure that agencies seamlessly and securely exchange health data with other agencies, other government entities, and with other public and private organizations Over time, FHAโ€™s focus and scope has expanded โ€ข To emphasize federal advancement of the national agenda for health IT โ€ข To provide enterprise architecture, standards adoption, tools and communication support 7
  • 8. FHA Participation FHA is working to engage the following agencies and other federal entities in initiatives such as the Nationwide Health Information Network, the Direct Project, EHR adoption and CONNECT โ€ข E-gov initiative managed by ONC within HHS โ€ข Many federal agencies participate 8
  • 9. Federal Health Architecture: Advancing National Health IT FHAโ€™s Early Years 2003 to โ€ข โ€ข July 2003 โ€“ OMB established FHA with HHS as the Managing Partner March 2004 โ€“ FHA designated by OMB as an e-gov 2008 initiative and a Line of Business initiative within the Federal Enterprise Architecture โ€ข In 2006, FHA was moved organizationally within HHS from the Office of the Chief Information Office to ONC Key Initiatives โ€ข Federal Health Enterprise Architecture โ€ข Consolidated Health Informatics (standards) โ€ข Standards Education and Coordination โ€ข Federal Health Information Planning and Reporting/Investment Planning 9
  • 10. Federal Health Architecture: Advancing National Health IT FHAโ€™s Evolution 2009 to โ€ข โ€ข 2009 โ€“ ARRA/HITECH 2010 โ€“ Patient Protection and Affordable Care Act (ACA) โ€ข 2010 โ€“ Federal CIOโ€Ÿs โ€œ25 Point Implementation Plan to 2011 โ€ข Reform Federal Information Technology Managementโ€ 2010 โ€“ Presidentโ€Ÿs Council of Advisors on Science and Technology (PCAST) โ€œReport to the President: Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: the Path Forwardโ€ Key Initiatives โ€ข Nationwide Health Information Network (NwHIN) Exchange โ€ข CONNECT 10
  • 11. Federal Health Architecture: Advancing National Health IT FHA in 2012: Strategy and Architecture New Governance โ€ข More strategic alignment within and across Federal partner agencies โ€ข Greater transparency and enhanced communications โ€ข Commitment to fulfilling original intent of FHA as E-Gov Line of Business Strategy Planning โ€ข FHA Strategic Plan nearing completion โ€ข FHA Line of Business (LoB) Service Plan delivered to OMB Interoperability Architecture โ€ข Identify current and planned data exchanges among Federal agencies and partners โ€ข Develop FHA public-facing portal โ€ข Align with standards harmonization efforts (e.g. Standards and Interoperability Framework) โ€ข Demonstrate exchange methods beyond Direct and SOA โ€“ RHEx pilots 11
  • 12. Federal Health Architecture: Advancing National Health IT FHA in 2012: Innovations RESTful Health Exchange (RHEx) โ€ข An open source project, sponsored by FHA โ€ข Demonstrated simple, secure, standards-based Web technologies for health information exchange Two Pilots โ€ข Telemedicine & Advanced Technology Research Center (TATRC) โ€ข Use Case: Consult/Referral โ€ข Secure Person to Person exchange โ€ข OpenID Connect for distributed user authentication โ€ข HealthInfoNet โ€ข Use Case: Populate clinical data repository with patient data from HER at small health care provider in medically underserved area to Maine HIE โ€ข Secure Machine to Machine exchange โ€ข OAuth2 for service to service authentication 12
  • 13. Federal Health Architecture: Advancing National Health IT FHA in 2012: Innovations CONNECT open source โ€ข CONNECT code on GitHub, sprint sessions open โ€ข Engaging open source community through code-a-thons, encouraging code contributions โ€ข Developing CONNECT 4.0, incorporating Direct specifications 13
  • 14. Partnership with eHealth Exchange NwHIN Exchange is now eHealth Exchange โ€ข Transitioned from ONC federal program to a public/private collaboration โ€ข Healtheway, a non-profit, is supporting eHealth Exchange operations โ€ข Testing and onboarding โ€ข Maintaining DURSA, and operating policies and procedures โ€ข Service registry and digital certificates โ€ข CONNECT is a gateway to eHealth Exchange 14
  • 15. FHA Strategic Plan โ€“ Vision A Federal health information technology environment that is interoperable with the private sector and supports the Presidentโ€Ÿs health information technology plan enabling better care, increased efficiency, and improved population health 15
  • 16. Federal Health Architecture: FHA Guiding Advancing National Health IT Principles FHA Moving Forward: 2013 and Beyond Stakeholder Engagement STRATEGIC GOALS Establish a unified Federal voice on health data exchange and interoperability Demonstrate through Pilots โ€ข Establish FHA as a โ€œconvener of statureโ€, and broaden participation โ€ข Expand outreach and access to tools Open Communication Achieve adoption of interoperability specifications, leading and Transparency to active data exchange in the Federal health community โ€ข Support S&I Framework by providing Federal use cases Commitment and pilots to Action โ€ข Enable FHA partners to move from legacy to new solutions in effective, coordinated manner Align Federal policies in healthcare data exchange Focus on Specifications โ€ข Provide a forum of cataloging and aligning Federal policies and practices 16
  • 17. Comments/Questions? Comments/Questions? 17
  • 18. Stay connected, communicate and collaborate โ€ข Find out more about FHA on the ONC website: http://www.healthit.gov/ โ€ข Contact us at: federal.health@hhs.gov โ€ข Subscribe, watch, and share: @ONC_FHA, @CONNECT_Project Federal Health Architecture http://www.flickr.com/photos/federalhealtharchitecture/ 18