The Direct Project aims to create standards and services to enable secure and meaningful health information exchange over the internet between known participants. It addresses current issues with communication relying mainly on mail and fax by providing a secure electronic alternative. The Direct Project specifications are developed collaboratively by over 50 organizations and 200 participants through weekly calls and meetings. The end goal is widespread adoption of the Direct standards by late 2012 to facilitate health information exchange and help meet meaningful use requirements.
The radiology department at
Baton Rouge General Medical
Center takes pride in using
advanced technologies to offer
top-notch care to patients and
unparalleled service to referring
physicians.
Healthcare Innovation Technology Group MeetingDavid Voran
Presentation to a Kansas City Healthcare Innovation Technology Group Meeting on June 28, 2011.
Describes Innovation processes, needs, some examples and advice for those creating innovative technology products to be used in Healthcare.
The radiology department at
Baton Rouge General Medical
Center takes pride in using
advanced technologies to offer
top-notch care to patients and
unparalleled service to referring
physicians.
Healthcare Innovation Technology Group MeetingDavid Voran
Presentation to a Kansas City Healthcare Innovation Technology Group Meeting on June 28, 2011.
Describes Innovation processes, needs, some examples and advice for those creating innovative technology products to be used in Healthcare.
Presentation at NeHC: Overview of ONC's health information exchange standards-selection activities. Focuses on HITSC, the S&I Framework, and the S&I Query Health Initiative.
Final Master's Defense Presentation : Policy-driven Security Management in Ga...Clinton DSouza
As part of a Cisco Inc. funded project, I worked with Dr. Gail-Joon Ahn to propose a Policy Management framework to address secure collaboration and communication between disparate systems and Internet of Thing devices. We took this research one step further by proposing a robust, interacting and responsive edge-based infrastructure which we termed GORE computing. The Policy Management framework thus proposed in this computing paradigm is generic in nature with the intention of it being capable for utilization in futuristic edge-based computing paradigms for IoT based devices.
ENCRYPTION BASED WATERMARKING TECHNIQUE FOR SECURITY OF MEDICAL IMAGEijcsit
This paper proposes an encryption-based image watermarking scheme for medical images using a customized quantization of wavelet coefficient and a crypto system based on the chaotic cipher of Singular Value Decomposition (SVD). In order to spread the robustness of our algorithm and provide extra security, an improved SVD-CHAOS embedding and extraction procedure has been used to scramble the watermark logo in the preprocessing step of the proposed method. In the process of watermark embedding, an R-level discrete wavelet transform was applied to the host image. The high frequency wavelet coefficients are selected to carry these scrambled-watermarks by using adaptive quantization low bit modulation (LBM). The proposed image watermarking method endures entirety attacks and rightly extracts the hidden watermark without significant degradation in the image quality, Thus, when the Peak Signal to Noise Ratio (PSNR) and Normalized Correlation (NC) performance of the proposed algorithm is compared with other related techniques.
FEATURE EXTRACTION METHODS FOR IRIS RECOGNITION SYSTEM: A SURVEYijcsit
Protection has become one of the biggest fields of study for several years, however the demand for this is growing exponentially mostly with rise in sensitive data. The quality of the research can differ slightly from any workstation to cloud, and though protection must be incredibly important all over. Throughout the past two decades, sufficient focus has been given to substantiation along with validation in the technology model. Identifying a legal person is increasingly become the difficult activity with the progression of time. Some attempts are introduced in that same respect, in particular by utilizing human movements such as fingerprints, facial recognition, palm scanning, retinal identification, DNA checking, breathing, speech checker, and so on. A number of methods for effective iris detection have indeed been suggested and researched. A general overview of current and state-of-the-art approaches to iris recognition is presented in this paper. In addition, significant advances in techniques, algorithms, qualified classifiers, datasets and methodologies for the extraction of features are also discussed.
A Prescription for Achieving Long-Term EMR Adoptionslvhit
Dr. Haugen presents how the economic, political and social pressures on the healthcare will inevitably change the shape of this industry. Topics include how the HITECH Act provides us with an opportunity, but requires significant changes in how we implement Electronic Medical Records (EMR) to ensure the transformation results in increased healthcare quality, error prevention, reduced healthcare costs and increased efficiency. The terms implementation and adoption are often used interchangeably, but the outcomes from them are very different. Moving from an EMR implementation focus to an EMR adoption focus requires a significant overhaul in how we think, how we lead, and how we behave.
A Proactive Approach in Network Forensic Investigation ProcessEditor IJCATR
nformation Assurance and Security (IAS) is a crucial component in the corporate environment to ensure that the secrecy of
sensitive data is protected, the integrity of important data is not violated, and the availability of critical systems is guaranteed. The
advancement of Information communication and technology into a new era and domain such as mobility and Internet of Things,
its ever growing user’s base and sophisticated cyber-attacks forces the organizations to deploy automated and robust defense
mechanism to manage resultant digital security incidences in real time. Digital forensic is a scientific process that facilitates
detection of illegal activities and in-appropriate behaviors using scientific tools, techniques and investigation frameworks. This
research aims at identifying processes that facilitate and improves digital forensic investigation process. Existing digital forensic
framework will be reviewed and the analysis will be compiled toderive a network forensic investigation framework that include
evidence collection, preservation and analysis at a sensor level and in real time. It is aimed to discover complete relationship with
optimal performance among known and unseen/new alerts generated by multiple network sensors in order to improve the quality
of alert and recognize attack strategy
Advance Diagnostic Tool for Android Devices: A Performance Analyzing Tool for...dbpublications
Abstract— this paper will provide the diagnostic tool solution for the measurement of values with proper units from various signals of Android Device. This application will be used for concluding the signal strength from various Transmitters; Trans receivers of mobile device. This includes GPS Receiver, Acceleration & Gravity Sensor, Rotation Sensor, Magnetic Sensors, Orientation Sensor, Relative Humidity Sensor, Proximity Sensor, Cell Network receivers & Wi-Fi Receiver. This paper provides the diagnostic tool for all the above said components of mobile device with appropriate units.
Medting International Telestroke NetworkMiguel Cabrer
Project Presentation
First International Telestroke Network sample video. Department of Neurology (Mayo Clinic, Arizona). Use of Medting as second opinion platform to share and discuss clinical cases between different countries. In the video a sample dialogue between Mayo Clinic (Dr. Bart Demaerschalk, Vascular Neurology) and Hotel Dieu Grace (Dr. Goron Vail, Emergency Medicine, Canada).
Presented by Dr. Demaerschalk
Technology used: Medting.com
oT applications usually rely on cloud computing services to perform data analysis such as filtering,
aggregation, classification, pattern detection, and prediction. When applied to specific domains, the IoT
needs to deal with unique constraints. Besides the hostile environment such as vibration and electric-
magnetic interference, resulting in malfunction, noise, and data loss, industrial plants often have Internet
access restricted or unavailable, forcing us to design stand-alone fog and edge computing solutions.
Opportunity Analysis and Strategy Development for smartphone mobile medical a...Damon Gjording
Scenario analysis, opportunity analysis, scenario identification and strategy development for smartphone mobile medical applications. Analysis I conducted using various innovation and scenario planning tools. Pre startup idea development
Matt Woodhill of Resilient Network Systems, and Brian Ahier of Gorge Health Connect, both long time CHC members, introduce these pilots and what the pilots will make possible in the near future. The webinar includes a discussion of pilots related to the National Strategy for Trusted Identities in Cyberspace, or NISTIC.
Avado CEO Dave Chase's presentation to the Collaborative Health Consortium's weekly Pilots and Collaborations Webinar. Dave is doing some leading edge thinking on collaborative care.
Presentation at NeHC: Overview of ONC's health information exchange standards-selection activities. Focuses on HITSC, the S&I Framework, and the S&I Query Health Initiative.
Final Master's Defense Presentation : Policy-driven Security Management in Ga...Clinton DSouza
As part of a Cisco Inc. funded project, I worked with Dr. Gail-Joon Ahn to propose a Policy Management framework to address secure collaboration and communication between disparate systems and Internet of Thing devices. We took this research one step further by proposing a robust, interacting and responsive edge-based infrastructure which we termed GORE computing. The Policy Management framework thus proposed in this computing paradigm is generic in nature with the intention of it being capable for utilization in futuristic edge-based computing paradigms for IoT based devices.
ENCRYPTION BASED WATERMARKING TECHNIQUE FOR SECURITY OF MEDICAL IMAGEijcsit
This paper proposes an encryption-based image watermarking scheme for medical images using a customized quantization of wavelet coefficient and a crypto system based on the chaotic cipher of Singular Value Decomposition (SVD). In order to spread the robustness of our algorithm and provide extra security, an improved SVD-CHAOS embedding and extraction procedure has been used to scramble the watermark logo in the preprocessing step of the proposed method. In the process of watermark embedding, an R-level discrete wavelet transform was applied to the host image. The high frequency wavelet coefficients are selected to carry these scrambled-watermarks by using adaptive quantization low bit modulation (LBM). The proposed image watermarking method endures entirety attacks and rightly extracts the hidden watermark without significant degradation in the image quality, Thus, when the Peak Signal to Noise Ratio (PSNR) and Normalized Correlation (NC) performance of the proposed algorithm is compared with other related techniques.
FEATURE EXTRACTION METHODS FOR IRIS RECOGNITION SYSTEM: A SURVEYijcsit
Protection has become one of the biggest fields of study for several years, however the demand for this is growing exponentially mostly with rise in sensitive data. The quality of the research can differ slightly from any workstation to cloud, and though protection must be incredibly important all over. Throughout the past two decades, sufficient focus has been given to substantiation along with validation in the technology model. Identifying a legal person is increasingly become the difficult activity with the progression of time. Some attempts are introduced in that same respect, in particular by utilizing human movements such as fingerprints, facial recognition, palm scanning, retinal identification, DNA checking, breathing, speech checker, and so on. A number of methods for effective iris detection have indeed been suggested and researched. A general overview of current and state-of-the-art approaches to iris recognition is presented in this paper. In addition, significant advances in techniques, algorithms, qualified classifiers, datasets and methodologies for the extraction of features are also discussed.
A Prescription for Achieving Long-Term EMR Adoptionslvhit
Dr. Haugen presents how the economic, political and social pressures on the healthcare will inevitably change the shape of this industry. Topics include how the HITECH Act provides us with an opportunity, but requires significant changes in how we implement Electronic Medical Records (EMR) to ensure the transformation results in increased healthcare quality, error prevention, reduced healthcare costs and increased efficiency. The terms implementation and adoption are often used interchangeably, but the outcomes from them are very different. Moving from an EMR implementation focus to an EMR adoption focus requires a significant overhaul in how we think, how we lead, and how we behave.
A Proactive Approach in Network Forensic Investigation ProcessEditor IJCATR
nformation Assurance and Security (IAS) is a crucial component in the corporate environment to ensure that the secrecy of
sensitive data is protected, the integrity of important data is not violated, and the availability of critical systems is guaranteed. The
advancement of Information communication and technology into a new era and domain such as mobility and Internet of Things,
its ever growing user’s base and sophisticated cyber-attacks forces the organizations to deploy automated and robust defense
mechanism to manage resultant digital security incidences in real time. Digital forensic is a scientific process that facilitates
detection of illegal activities and in-appropriate behaviors using scientific tools, techniques and investigation frameworks. This
research aims at identifying processes that facilitate and improves digital forensic investigation process. Existing digital forensic
framework will be reviewed and the analysis will be compiled toderive a network forensic investigation framework that include
evidence collection, preservation and analysis at a sensor level and in real time. It is aimed to discover complete relationship with
optimal performance among known and unseen/new alerts generated by multiple network sensors in order to improve the quality
of alert and recognize attack strategy
Advance Diagnostic Tool for Android Devices: A Performance Analyzing Tool for...dbpublications
Abstract— this paper will provide the diagnostic tool solution for the measurement of values with proper units from various signals of Android Device. This application will be used for concluding the signal strength from various Transmitters; Trans receivers of mobile device. This includes GPS Receiver, Acceleration & Gravity Sensor, Rotation Sensor, Magnetic Sensors, Orientation Sensor, Relative Humidity Sensor, Proximity Sensor, Cell Network receivers & Wi-Fi Receiver. This paper provides the diagnostic tool for all the above said components of mobile device with appropriate units.
Medting International Telestroke NetworkMiguel Cabrer
Project Presentation
First International Telestroke Network sample video. Department of Neurology (Mayo Clinic, Arizona). Use of Medting as second opinion platform to share and discuss clinical cases between different countries. In the video a sample dialogue between Mayo Clinic (Dr. Bart Demaerschalk, Vascular Neurology) and Hotel Dieu Grace (Dr. Goron Vail, Emergency Medicine, Canada).
Presented by Dr. Demaerschalk
Technology used: Medting.com
oT applications usually rely on cloud computing services to perform data analysis such as filtering,
aggregation, classification, pattern detection, and prediction. When applied to specific domains, the IoT
needs to deal with unique constraints. Besides the hostile environment such as vibration and electric-
magnetic interference, resulting in malfunction, noise, and data loss, industrial plants often have Internet
access restricted or unavailable, forcing us to design stand-alone fog and edge computing solutions.
Opportunity Analysis and Strategy Development for smartphone mobile medical a...Damon Gjording
Scenario analysis, opportunity analysis, scenario identification and strategy development for smartphone mobile medical applications. Analysis I conducted using various innovation and scenario planning tools. Pre startup idea development
Matt Woodhill of Resilient Network Systems, and Brian Ahier of Gorge Health Connect, both long time CHC members, introduce these pilots and what the pilots will make possible in the near future. The webinar includes a discussion of pilots related to the National Strategy for Trusted Identities in Cyberspace, or NISTIC.
Avado CEO Dave Chase's presentation to the Collaborative Health Consortium's weekly Pilots and Collaborations Webinar. Dave is doing some leading edge thinking on collaborative care.
Brian Prestwich, MD
Assistant Professor of Family Medicine
Keck School of Medicine of the University of Southern California
Thursday, February 23, 2012
At the American Telemedicine Association 2022 Conference, IEEE SA presented perspectives on where the development of global technical and data standards in remote patient monitoring (RPM) will support the future of innovation while moving the needle in patient-centered care.
According to the Leapfrog Group, hospitals in the US pay a surcharge of $5900-$7800 per admission to cover a wide range of medical errors. Smart point-of-care systems address the source of these errors to help reduce healthcare expenditures while improving patient care. The systems reliably connect and transmit critical data for medical devices, clinicians and patients – ensuring information is shared exactly when and where it's needed most.
However, it is extremely challenging to address data interoperability, safety, security and integration with other systems in today's healthcare environment. As data volume grows and becomes increasingly valuable, these issues will affect system and data architecture, especially with the rise of smart analytics used to improve the quality of treatment. Join Tracy Rausch, founder and CTO of DocBox Inc., and Sumeet Shendrikar, RTI Solutions Architect, as they discuss the challenges of developing smarter point-of-care systems and how a data-centric architecture can ensure the right data gets to the right place at the right time to improve patient healthcare.
The Certification team from ONC's Office of Standards & Interoperability will host an interactive session that provides information on the EHR Certification program and provides attendees the opportunity to ask questions and discuss thoughts with the panelists.
The need for interoperability in blockchain-based initiatives to facilitate c...Massimiliano Masi
Slides for the IEEE Blockchain Symposium in Glasgow, https://blockchain.ieee.org/standards/clinicaltrialseurope18, https://blockchain.ieee.org/standards/clinicaltrialseurope18/speakers
Presentation slides for Dave Whitlinger, Executive Director of the NY eHealth Collaborative, from the HIMSS'12 eCollaborationForum, February 23rd, 2012
Encryption in Microsoft 365 - ExpertsLive Netherlands 2024Albert Hoitingh
In this session I delve into the encryption technology used in Microsoft 365 and Microsoft Purview. Including the concepts of Customer Key and Double Key Encryption.
Elevating Tactical DDD Patterns Through Object CalisthenicsDorra BARTAGUIZ
After immersing yourself in the blue book and its red counterpart, attending DDD-focused conferences, and applying tactical patterns, you're left with a crucial question: How do I ensure my design is effective? Tactical patterns within Domain-Driven Design (DDD) serve as guiding principles for creating clear and manageable domain models. However, achieving success with these patterns requires additional guidance. Interestingly, we've observed that a set of constraints initially designed for training purposes remarkably aligns with effective pattern implementation, offering a more ‘mechanical’ approach. Let's explore together how Object Calisthenics can elevate the design of your tactical DDD patterns, offering concrete help for those venturing into DDD for the first time!
Transcript: Selling digital books in 2024: Insights from industry leaders - T...BookNet Canada
The publishing industry has been selling digital audiobooks and ebooks for over a decade and has found its groove. What’s changed? What has stayed the same? Where do we go from here? Join a group of leading sales peers from across the industry for a conversation about the lessons learned since the popularization of digital books, best practices, digital book supply chain management, and more.
Link to video recording: https://bnctechforum.ca/sessions/selling-digital-books-in-2024-insights-from-industry-leaders/
Presented by BookNet Canada on May 28, 2024, with support from the Department of Canadian Heritage.
Securing your Kubernetes cluster_ a step-by-step guide to success !KatiaHIMEUR1
Today, after several years of existence, an extremely active community and an ultra-dynamic ecosystem, Kubernetes has established itself as the de facto standard in container orchestration. Thanks to a wide range of managed services, it has never been so easy to set up a ready-to-use Kubernetes cluster.
However, this ease of use means that the subject of security in Kubernetes is often left for later, or even neglected. This exposes companies to significant risks.
In this talk, I'll show you step-by-step how to secure your Kubernetes cluster for greater peace of mind and reliability.
Essentials of Automations: Optimizing FME Workflows with ParametersSafe Software
Are you looking to streamline your workflows and boost your projects’ efficiency? Do you find yourself searching for ways to add flexibility and control over your FME workflows? If so, you’re in the right place.
Join us for an insightful dive into the world of FME parameters, a critical element in optimizing workflow efficiency. This webinar marks the beginning of our three-part “Essentials of Automation” series. This first webinar is designed to equip you with the knowledge and skills to utilize parameters effectively: enhancing the flexibility, maintainability, and user control of your FME projects.
Here’s what you’ll gain:
- Essentials of FME Parameters: Understand the pivotal role of parameters, including Reader/Writer, Transformer, User, and FME Flow categories. Discover how they are the key to unlocking automation and optimization within your workflows.
- Practical Applications in FME Form: Delve into key user parameter types including choice, connections, and file URLs. Allow users to control how a workflow runs, making your workflows more reusable. Learn to import values and deliver the best user experience for your workflows while enhancing accuracy.
- Optimization Strategies in FME Flow: Explore the creation and strategic deployment of parameters in FME Flow, including the use of deployment and geometry parameters, to maximize workflow efficiency.
- Pro Tips for Success: Gain insights on parameterizing connections and leveraging new features like Conditional Visibility for clarity and simplicity.
We’ll wrap up with a glimpse into future webinars, followed by a Q&A session to address your specific questions surrounding this topic.
Don’t miss this opportunity to elevate your FME expertise and drive your projects to new heights of efficiency.
DevOps and Testing slides at DASA ConnectKari Kakkonen
My and Rik Marselis slides at 30.5.2024 DASA Connect conference. We discuss about what is testing, then what is agile testing and finally what is Testing in DevOps. Finally we had lovely workshop with the participants trying to find out different ways to think about quality and testing in different parts of the DevOps infinity loop.
Dev Dives: Train smarter, not harder – active learning and UiPath LLMs for do...UiPathCommunity
💥 Speed, accuracy, and scaling – discover the superpowers of GenAI in action with UiPath Document Understanding and Communications Mining™:
See how to accelerate model training and optimize model performance with active learning
Learn about the latest enhancements to out-of-the-box document processing – with little to no training required
Get an exclusive demo of the new family of UiPath LLMs – GenAI models specialized for processing different types of documents and messages
This is a hands-on session specifically designed for automation developers and AI enthusiasts seeking to enhance their knowledge in leveraging the latest intelligent document processing capabilities offered by UiPath.
Speakers:
👨🏫 Andras Palfi, Senior Product Manager, UiPath
👩🏫 Lenka Dulovicova, Product Program Manager, UiPath
GDG Cloud Southlake #33: Boule & Rebala: Effective AppSec in SDLC using Deplo...James Anderson
Effective Application Security in Software Delivery lifecycle using Deployment Firewall and DBOM
The modern software delivery process (or the CI/CD process) includes many tools, distributed teams, open-source code, and cloud platforms. Constant focus on speed to release software to market, along with the traditional slow and manual security checks has caused gaps in continuous security as an important piece in the software supply chain. Today organizations feel more susceptible to external and internal cyber threats due to the vast attack surface in their applications supply chain and the lack of end-to-end governance and risk management.
The software team must secure its software delivery process to avoid vulnerability and security breaches. This needs to be achieved with existing tool chains and without extensive rework of the delivery processes. This talk will present strategies and techniques for providing visibility into the true risk of the existing vulnerabilities, preventing the introduction of security issues in the software, resolving vulnerabilities in production environments quickly, and capturing the deployment bill of materials (DBOM).
Speakers:
Bob Boule
Robert Boule is a technology enthusiast with PASSION for technology and making things work along with a knack for helping others understand how things work. He comes with around 20 years of solution engineering experience in application security, software continuous delivery, and SaaS platforms. He is known for his dynamic presentations in CI/CD and application security integrated in software delivery lifecycle.
Gopinath Rebala
Gopinath Rebala is the CTO of OpsMx, where he has overall responsibility for the machine learning and data processing architectures for Secure Software Delivery. Gopi also has a strong connection with our customers, leading design and architecture for strategic implementations. Gopi is a frequent speaker and well-known leader in continuous delivery and integrating security into software delivery.
Smart TV Buyer Insights Survey 2024 by 91mobiles.pdf91mobiles
91mobiles recently conducted a Smart TV Buyer Insights Survey in which we asked over 3,000 respondents about the TV they own, aspects they look at on a new TV, and their TV buying preferences.
Connector Corner: Automate dynamic content and events by pushing a buttonDianaGray10
Here is something new! In our next Connector Corner webinar, we will demonstrate how you can use a single workflow to:
Create a campaign using Mailchimp with merge tags/fields
Send an interactive Slack channel message (using buttons)
Have the message received by managers and peers along with a test email for review
But there’s more:
In a second workflow supporting the same use case, you’ll see:
Your campaign sent to target colleagues for approval
If the “Approve” button is clicked, a Jira/Zendesk ticket is created for the marketing design team
But—if the “Reject” button is pushed, colleagues will be alerted via Slack message
Join us to learn more about this new, human-in-the-loop capability, brought to you by Integration Service connectors.
And...
Speakers:
Akshay Agnihotri, Product Manager
Charlie Greenberg, Host
JMeter webinar - integration with InfluxDB and GrafanaRTTS
Watch this recorded webinar about real-time monitoring of application performance. See how to integrate Apache JMeter, the open-source leader in performance testing, with InfluxDB, the open-source time-series database, and Grafana, the open-source analytics and visualization application.
In this webinar, we will review the benefits of leveraging InfluxDB and Grafana when executing load tests and demonstrate how these tools are used to visualize performance metrics.
Length: 30 minutes
Session Overview
-------------------------------------------
During this webinar, we will cover the following topics while demonstrating the integrations of JMeter, InfluxDB and Grafana:
- What out-of-the-box solutions are available for real-time monitoring JMeter tests?
- What are the benefits of integrating InfluxDB and Grafana into the load testing stack?
- Which features are provided by Grafana?
- Demonstration of InfluxDB and Grafana using a practice web application
To view the webinar recording, go to:
https://www.rttsweb.com/jmeter-integration-webinar
Kubernetes & AI - Beauty and the Beast !?! @KCD Istanbul 2024Tobias Schneck
As AI technology is pushing into IT I was wondering myself, as an “infrastructure container kubernetes guy”, how get this fancy AI technology get managed from an infrastructure operational view? Is it possible to apply our lovely cloud native principals as well? What benefit’s both technologies could bring to each other?
Let me take this questions and provide you a short journey through existing deployment models and use cases for AI software. On practical examples, we discuss what cloud/on-premise strategy we may need for applying it to our own infrastructure to get it to work from an enterprise perspective. I want to give an overview about infrastructure requirements and technologies, what could be beneficial or limiting your AI use cases in an enterprise environment. An interactive Demo will give you some insides, what approaches I got already working for real.
2. Direct Project
What is Direct?
A project to create the set of
standards and services that,
with a policy framework, enable
simple, directed, routed, scalable
transport over the Internet to be
used for secure and meaningful
exchange between known
participants in support of
meaningful use
3. Direct Project: Why is there a need for Direct?
Communication of health information among providers and patients still mainly relies on
mail or fax
• Slow, inconvenient, expensive
• Health information and history is lost or hard to find in paper charts
Current forms of electronic communication may not be secure
• Encryption features of off-the-shelf e-mail clients not often used in healthcare communications
today
Physicians need to transport and share clinical content electronically in order to satisfy
Stage 1 Meaningful Use requirements.
• Need to meet physicians where they are now
• Direct will be one of the communication methods in the Nationwide Health Information Network
Sources: http://www.flickr.com/photos/dougww/922328173/ http://www.flickr.com/photos/greenlagirl/154148230/sizes/o/ http://www.flickr.com/photos/kenjonbro/3418425029/sizes/m/
4. Direct Project
and other Information Exchange
The Direct Project doesn’t replace other
ways information is exchanged
electronically today, but it might Nationwide Health
augment them. Information Network
Exchange
The Direct Project supports simple use Direct Project
cases in order to speed adoption, but
other methods of exchange might be
suited for other scenarios.
The Direct Project was designed to
coexist gracefully with existing
protocols for data exchange.
Nearby EMR to
HIE EMR (HIE)
The Direct Project seeks to replace slow,
inconvenient, and expensive methods
of exchange (like paper, fax, or carrier Health information exchange:
pigeon) and provide a future path to a puzzle with many pieces
advanced interoperability.
5. Direct Project
Secure Internet-based Direct Communications
Direct Project specifies a simple, secure,
scalable, standards-based way for
participants to send encrypted health
information directly to known, trusted
recipients over the Internet.
b.wells@direct.aclinic.org h.elthie@direct.ahospital.org
» Simple. Connects healthcare stakeholders through universal
addressing using simple push of information.
» Secure. Users can easily verify messages are complete and
not tampered with in travel.
» Scalable. Enables Internet scale with no need for central
network authority.
» Standards-based. Built on common Internet standards for
secure e-mail communication.
6. Direct Project
Facilitates Meaningful Use
Direct Project facilitates the communication of many different kinds of
content necessary to fulfill meaningful use requirements.
Examples of Meaningful Use Content
» Patients:
• Health information
• Discharge instructions
• Clinical summaries
• Reminders
DIRECT
» Public Health:
• Immunization registries
b.wells@direct.aclinic.org • Syndromic surveillance
1) Get a Direct Address (e-mail-like)
• Laboratory Reporting
and a security certificate
2) Send mail securely using most e- » Other Providers/Authorized Entities:
mail clients OR contract with a • Clinical information
HIO or HISP that performs
authentication, encryption and • Labs – test results
trust verification on your behalf • Referrals – summary of care record
7. Direct Project
Organization (as of November 2010)
The Direct Project represents over 50 organizations and over 200
participants.
• Members participate in the Implementation Group and one or more
of 6 workgroups.
Implementation Group
(50+ organizations, 200+ participants)
Security Best Implementation Documentation Reference
Communications
and Trust Practices Geographies and Testing Implementation
8. Direct Project
Close to 200 Participants in over 50 Organizations
» Allscripts » Massachusetts eHealth Collaborative
» American Academy of Family Physicians » MedAllies
» Atlas Development » MIE/NoMoreClipboard.com
» Axolotl » Medical University of SC
» CareSpark/MobileMD/Serendipity Health » Medicity
» Cautious Patient » MedNet
» Cerner » MedPATH Networks
» Clinical Groupware Collaborative » MedPlus/Quest Diagnostics
» Covisint » Microsoft
» CSC » Mirth Corporation
» eClinicalWorks » MOSS
» Emdeon » NextGen
» Epic » NIH NCI
» FEI » NIST
» Garden State Health Systems » NYC Dept. of Health and Mental Hygiene
» GE » Oregon HIE Planning Team
» Google » Redwood MedNet
» Greenway Medical Technologies » RelayHealth
» Harris Corporation » Rhode Island Quality Institute
» High Pine Associates » Secure Exchange Solutions
» HLN Consulting, LLC » Siemens
» IBM » South Carolina SDE
» Indiana State Department of Health » Surescripts
» Inpriva » Techsant Technologies
» Intel » TN State HIE
» Kryptiq » VA
» LabCorp » VisionShare
9. Direct Project
The Process
Direct standards and specifications are developed by a group of public-
private stakeholders. Weekly teleconferences and periodic face-to-face
meetings facilitate active collaboration.
Direct Project Output:
• Standards and Service Definitions
• Implementation Guides Vendors
• Reference Implementation incorporate
• Pilot project testing and real-world reference
implementation implementation
into HIT products
Wide-scale adoption of Direct
standards by late 2012 First phase
grounded in
real-world
pilot projects
Incorporation of implemented
HITPC, HITSC, by early
and ONC policy 2011
guidance
11. Direct Project
High quality open source libraries
» The history of the Internet shows the power of permissively licensed
open source in driving standardization:
• TCP/IP: Berkeley TCP/IP stack
• DNS: BIND
• HTTP: Apache
» Successful open standards have easily accessible high-quality libraries
trivially available to developers, including high quality documentation
» A key deliverable of Direct Project is a BSD-licensed software stack
enabling:
• Client-side connectivity, for EHRs, EHR Modules, PHRs, etc. and
• Server-side connectivity for “out of the box” HIOs and Health
Information Service Providers (HISPs)
12. Direct Project: Real-world Implementation
Direct Project is being demonstrated in real-world pilots across the country
and is in production use by HIEs, EHRs, and PCHRs
Gorge Health Connect, Inc. (OR) Rhode Island
VisionShare (MN) Quality Institute
MedAllies (NY) (RI)
Redwood MedNet (CA) Medical Professional
Services (CT)
VisionShare (OK)
CareSpark (TN)
Direct Project is architected for rapid
adoption by:
• Thousands of hospitals
• Hundreds of thousands of physicians
• Millions of providers
• Tens (or hundreds?) of millions of patients
• Many other stakeholders in healthcare
13. Direct Project
Four Steps to Direct
Successful implementation and adoption of Direct relies on four key steps.
1 2 3 4
Pilot Demonstrations
Vendor Adoption
Policy Guidance
Reference Implementation: Solid, simple set of code and strong documentation.
Pilot Demonstrations: Successful incorporation of reference implementation in select
regions to learn from pilot experience for broader standards adoption.
• Vendor Adoption: Base interfaces available for purchase and code and software
installed in all HIT exchange products.
• Scale Through Policy & Governance: Uniform trust framework for broad inter-network
exchange.