Updates on the Western States Consortium

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Updates on the Western States Consortium

  1. 1. Update on the Western States Consortium Robert M. Cothren, PhD California Health eQuality Program IPHI / UC Davis Health System January 28, 2013 3:00PM
  2. 2. Who is the WSC? Office of the National Coordinator for 1 Health Information Technology
  3. 3. What are we doing?Investigating the policies, procedures, andtechnologies that allow and promote interstateexchange of health information. Office of the National Coordinator for 2 Health Information Technology
  4. 4. What is the issue?Use case…Using Direct to exchange clinical information betweenproviders across state lines for treatment purposes. A simple use case that allows us to concentrate on interstate exchange. Office of the National Coordinator for 3 Health Information Technology
  5. 5. Who is participating… as proposed? California Oregon• One data sharing agreement Focus on the issues of• One exchange of digital certificates interstate exchange.• One exchange of user addresses Office of the National Coordinator for 4 Health Information Technology
  6. 6. Who will be participating… soon? Alaska Oregon California• Six data sharing agreements Focus on the issues of• Six exchanges of digital certificates scalable trust.• Six (ongoing) exchanges of user addresses Office of the National Coordinator for 5 Health Information Technology
  7. 7. Again… What is the issue?Use case…Using Direct to exchange clinical information betweenproviders across state lines for treatment purposes. Really about scalable trust. Two important components… 1. Establishing inter-organizational trust. 2. Discovering how to communicate with others. Office of the National Coordinator for 6 Health Information Technology
  8. 8. How is trusted exchange established? The Western States Consortium Trust Community Developed “umbrella governance organization”: signatories to an MOU establishing the Governance Body. – Currently includes California, Oregon, and Alaska. – Other core states evaluating when they can join. Office of the National Coordinator for 7 Health Information Technology
  9. 9. How is trusted exchange established? The Western States Consortium Trust Community Developed “umbrella governance organization”: signatories to an MOU establishing the Governance Body. Developed a set of Eligibility Criteria for Qualified Entities joining the WSC Trust Community. – Based on… …Direct Applicability Statement, and  technical standards …ONC guidance on directed exchange.  policies and procedures – Memorialized in policies and procedures. Office of the National Coordinator for 8 Health Information Technology
  10. 10. How is trusted exchange established? The Western States Consortium Trust Community Developed “umbrella governance organization”: signatories to an MOU establishing the Governance Body. Developed a set of Eligibility Criteria for Qualified Entities joining the WSC Trust Community. Developed procedures for collecting, managing, and distributing a Trust Bundle that identifies Qualified Entities. – Manual process now. – Move to a standardized process under development. Office of the National Coordinator for 9 Health Information Technology
  11. 11. How is trusted exchange established? The Western States Consortium Trust Community Developed “umbrella governance organization”: signatories to an MOU establishing the Governance Body. Developed a set of Eligibility Criteria for Qualified Entities joining the WSC Trust Community. Developed procedures for collecting, managing, and distributing a Trust Bundle that identifies Qualified Entities. Testing in a pilot. – Adding states to the Governance Body. – Adding Qualified Entities to the Trust Community. – Updating Trust Bundle distribution procedures. Office of the National Coordinator for 10 Health Information Technology
  12. 12. What is this “Trust Bundle”?• Collection of public digital Add New Qualified Entity to Trust Community Governance Body Party State Trust Bundle Coordinator New Qualified Entity POC Existing Qualified Entity POCs certificates or “trust anchors”. From “Eval of Qualified Entity” – Establishes the electronic identity Requests that Qualified Entity be added to Trust Community. Requests Trust Anchor. Returns Trust Anchor (via email). of members of the Trust Inspects Trust Anchor to verify it meets Eligibility Criteria. Community. Issues? yes Corrects issues. – Managed and published by the no Places Trust Anchor in test HISP. Governance Body. Sends trust anchor for test HISP (via Places trust anchor for test HISP in HISP. – Memorialized in policies, email). Conducts test of Conducts test of Trust Anchor Trust Anchor. procedures, and technology. Issues? yes Corrects issues. no Adds Trust Anchor to Trust Bundle. Notes successful Sends notice of addition to Trust addition to Trust Community. Community. Sends notice that Trust Bundle has been updated. Retrieves Trust Retrieves Trust Notes update to Bundle (via FTP) and Bundle (via FTP) and Trust Bundle. places in HISP. places in HISP. Office of the National Coordinator for 11 Health Information Technology
  13. 13. What about standards?• The WSC Trust Bundle is a low-tech solution examining policies and procedures for managing trust anchors. – Distribution: SFTP – Content: trust anchors in an SFTP directory – Change management: out-of-band email alerts• The developing standard… – Distribution: HTTP or HTTPS – Content: (optionally) signed PKCS7 container See the Direct Project Trust Bundle Sub Work Group at http://wiki.directproject.org/Trust+Bundle+Sub+Work+Group. Office of the National Coordinator for 12 Health Information Technology
  14. 14. Once more… What is the issue?Use case… Using Direct to exchange clinical information between providers across state lines for treatment purposes. Really about scalable trust. Two important components… 1. Establishing inter-organizational trust. 2. Discovering how to communicate with others. Office of the National Coordinator for 13 Health Information Technology
  15. 15. How are addresses discovered? Directory Services Developed architecture for distributed management of individual (and organizational) addresses. – States query each other. – The architecture within each state is up to the state. – California is also federating directories. Office of the National Coordinator for 14 Health Information Technology
  16. 16. How are addresses discovered? Directory Services Developed architecture for distributed management of individual (and organizational) addresses. Developing functional requirements and expected behavior for state-level directories. – To be memorialized in policies and procedures. – May include eligibility criteria for participating in Directory Services. Office of the National Coordinator for 15 Health Information Technology
  17. 17. How are addresses discovered? Directory Services Developed architecture for distributed management of individual (and organizational) addresses. Developing functional requirements and expected behavior for state-level directories. Developing standardized query for state-level directories. – Based on previous work. – In California, also being used for internal federation. Please let us know if you would like to participate! Office of the National Coordinator for 16 Health Information Technology
  18. 18. How are addresses discovered? Directory Services Developed architecture for distributed management of individual (and organizational) addresses. Developing functional requirements and expected behavior for state-level directories. Developing standardized query for state-level directories. Testing in a pilot. – Adding states to the architecture. – Adding local directories in California. – Learning how it all might work. Office of the National Coordinator for 17 Health Information Technology
  19. 19. What about standards?• Based on the work of other “standards” organizations. – IHE Healthcare Provider Directory (HPD) – S&I Framework guidance for queries – EHR|HIE Interoperability Workgroup (HPDPlus)• Developing standards… – HTTP and TLS – SOAP web services – HPD / HPDPlus data model – DSML query and response See the December HITRC PD CoP meeting for more… http://hitrc-collaborative.org/confluence/download/attachments/12419271/Provider+Directory+CoP+Membership+Mtg+2012+12+19+FINAL.pptx Office of the National Coordinator for 18 Health Information Technology
  20. 20. When can I see it? Overlapping Trust Communities WSC Trust Community CA Trust Community Office of the National Coordinator for 19 Health Information Technology
  21. 21. When can I see it? Distributed Directory Services CA State Directory Service OR State Directory Service RWMN Local Directory Service NCHIN Local Directory Service Office of the National Coordinator for 20 Health Information Technology
  22. 22. Questions?Office of the National Coordinator for 21 Health Information Technology

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