This document summarizes a demonstration of establishing trusted exchange among unaffiliated organizations. It introduces representatives from organizations in the Western States Consortium, which investigates policies and technologies for exchanging health information across state lines. The use case demonstrated using Direct to exchange clinical information between providers. It also discussed establishing inter-organizational trust and discovering communication partners through a distributed directory search architecture. The demonstration showed how scalable trust can be achieved through trust communities and bundles.

1. Establishing Trusted Exchange
Among Unaffiliated Organizations
A Replay of the Western States Consortium
Demonstration at the HIMSS Interoperability Showcase
20 March 2013

2. Today’s Players
In order of appearance…
• Robert Cothren, PhD
Technical Director, CHeQ Program, UC Davis Health System
• Chris Jioras
Project Manager, North Coast Health Information Network
• Sharon Wentz, RN
Business Development Coordinator, CareAccord™
• Jane McCord
Information Services Liaison, North Coast Health Information Network
• Will Ross
Project Manager, Redwood MedNet
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3. Western States Consortium
Investigating the policies, procedures, and technologies that
allow and promote interstate exchange of health information.
Use case…
Using Direct
to exchange clinical information
between providers
across state lines
for treatment purposes.
2

4. Scalable Trust
Use case…
• Exchange between providers across state lines for treatment purposes
…is really…
• An example of exchange between unaffiliated organizations.
Really about scalable trust.
Two important components…
1. Establishing inter-organizational trust.
2. Discovering how to communicate with others.
3

5. What you will see…
4

6. What you will see…
5

7. Start the demo…
6

8. Sidebar…
7

9. Distributed Directory Search
Architecture:
• States query each other State HISP
as peers AK State Directory
In CA:
• Use federated State HISP
directories
CA State Directory
A ? OR State Directory
• Rules govern
queries
? ? 1. CareAccord user requests address from CA.
2. CA determines where to send query.
3. CA forwards query to regional directories.
A A 4.
5.
Regional directories search and respond.
CA consolidates responses.
6. CA responds to CareAccord user.
Regional HISP Regional HISP
Regional HISP
8

10. Distributed Directory Search
Architecture:
• States query each other State HISP
as peers AK State Directory
?
In CA:
• Use federated State HISP
directories
CA State Directory
? A OR State Directory
• Rules govern
queries
A 1. NCHIN user requests address from OR/WSC.
2. CA determines where to send queries.
3. CA forwards query to state directories.
? 4.
5.
State directories search and respond.
CA consolidates responses.
6. CA responds to NCHIN user.
Regional HISP Regional HISP
Regional HISP
9

11. Distributed Directory Search
Architecture:
• States query each other State HISP
as peers AK State Directory
In CA:
• Use federated State HISP
directories
CA State Directory OR State Directory
• Rules govern
queries
A ? ? 1. NCHIN user requests address from CA.
2. CA determines where to send queries.
3. CA forwards query to regional directories.
? A 4.
5.
Regional directories search and respond.
CA consolidates responses.
A 6. CA responds to NCHIN user.
Regional HISP Regional HISP
Regional HISP
10

12. Back to the demo…
11

13. Sidebar…
12

14. Scalable Trust
• Trust Community: a group of organizations that elect to adopt a common set
of policies and processes in regard to health information exchange.
• Trust Bundles: the collection of trust anchors for members of a Trust
Community.
Moving from today’s world of … to tomorrow’s world of
point-to-point trust agreements… scalable trust.
Trust
Bundles
See http://bundles.hiecosystem.net/wsc/
13

15. Back to the demo…
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16. Questions…
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