Presentation slides for Dave Whitlinger, Executive Director of the NY eHealth Collaborative, from the HIMSS'12 eCollaborationForum, February 23rd, 2012
Challenges of Deploying Unified Communications and Integrated Collaborations ...idescitation
ccess to information holds the key to the
empowerment of everybody despite where they are living. This
research is to be carried out in respect of the people living in
developing countries, considering their plight and complex
geographical, demographic, social-economic conditions
surrounding the areas they live, which hinder access to
information and of professionals providing services such as
medical workers, which has led to high death rates and
development
stagnation.
Research
on
Unified
Communications and Integrated Collaborations (UCIC)
system in the health sector of developing countries comes in
to create a possible solution of bridging the digital canyon
among the communities. The system is meant to deliver
services in a seamless manner to assist health workers situated
anywhere to be accessed easily and access information which
will help in service delivery. The proposed UCIC provides the
most immersive telepresence experience for one-to-one or
many-to-many meetings. Extending to locations anywhere in
the world, the transformative platform delivers Ultra-low
operating costs through the use of general purpose networks
and using special lenses and track systems.
The aim is to identify challenges anticipated in the deployment
of the UCIC system in the health sector of developing countries
and recommend possible solutions. These recommendations
once adopted and implemented correctly will bring
enhancement to the speed and quality of services offered by
health workers. The capacities of UCIC will help health
workers shorten decision cycles, accelerate service delivery
and save lives by speeding access to information and by making
it possible for all health workers and patients to collaborate
everywhere.
Beyond EHR - Achieving Operational Efficiency Callum Bir
Callum Bir
IBC Asia 3rd Asia EHR Conference in held in Singapore November 2011
Callum chaired the workshop for the day with guests speakers from Singapore MOHH, HL7, etc.
Interconnected Health 2012 Hitech 3 Years Laterprivacypros
The Health Information Technology for Economic and Clinical Health Act or HITECH was passed by the Congress three years ago. Among its provisions, HITECH sought to strengthen privacy and security measures over health information. Specifically, it added new privacy and security requirements for business associates, established new breach notification requirements, and enhanced enforcement efforts.
Presentation slides for Dave Whitlinger, Executive Director of the NY eHealth Collaborative, from the HIMSS'12 eCollaborationForum, February 23rd, 2012
Challenges of Deploying Unified Communications and Integrated Collaborations ...idescitation
ccess to information holds the key to the
empowerment of everybody despite where they are living. This
research is to be carried out in respect of the people living in
developing countries, considering their plight and complex
geographical, demographic, social-economic conditions
surrounding the areas they live, which hinder access to
information and of professionals providing services such as
medical workers, which has led to high death rates and
development
stagnation.
Research
on
Unified
Communications and Integrated Collaborations (UCIC)
system in the health sector of developing countries comes in
to create a possible solution of bridging the digital canyon
among the communities. The system is meant to deliver
services in a seamless manner to assist health workers situated
anywhere to be accessed easily and access information which
will help in service delivery. The proposed UCIC provides the
most immersive telepresence experience for one-to-one or
many-to-many meetings. Extending to locations anywhere in
the world, the transformative platform delivers Ultra-low
operating costs through the use of general purpose networks
and using special lenses and track systems.
The aim is to identify challenges anticipated in the deployment
of the UCIC system in the health sector of developing countries
and recommend possible solutions. These recommendations
once adopted and implemented correctly will bring
enhancement to the speed and quality of services offered by
health workers. The capacities of UCIC will help health
workers shorten decision cycles, accelerate service delivery
and save lives by speeding access to information and by making
it possible for all health workers and patients to collaborate
everywhere.
Beyond EHR - Achieving Operational Efficiency Callum Bir
Callum Bir
IBC Asia 3rd Asia EHR Conference in held in Singapore November 2011
Callum chaired the workshop for the day with guests speakers from Singapore MOHH, HL7, etc.
Interconnected Health 2012 Hitech 3 Years Laterprivacypros
The Health Information Technology for Economic and Clinical Health Act or HITECH was passed by the Congress three years ago. Among its provisions, HITECH sought to strengthen privacy and security measures over health information. Specifically, it added new privacy and security requirements for business associates, established new breach notification requirements, and enhanced enforcement efforts.
Addressing the Healthcare Connectivity ChallengeTodd Winey
In healthcare, information accessibility can impact the outcome of a medical decision, or the success of a bundled payment initiative. To ensure that the right information is available at the right place and time, healthcare organizations typically have used HL7® interface engines to share data among clinical applications. But the demands on healthcare information technology are changing so rapidly that these simple engines are no longer sufficient.
Microsoft Unified Communications – Role in Healthcare Service Improvement Whi...Microsoft Private Cloud
Unified communications (UC) broadly defines a highly integrated
communications environment that combines, or unifies, text, voice,
video, and data communications in innovative ways to provide process
and productivity improvement. It provides for real-time delivery of
communications based on the preferred method and location of the
recipient and facilitates the incorporation of all information sources
pertinent to the communication. The technologies to support UC can
include email, telephony, voicemail, instant messaging (IM), video,
Web conferencing, and short message service (SMS), which can be
brought together in various combinations in real time and coordinated.
The benefits of UC are amplified in those organizations in which the
workers are highly mobile and communication between them is both
critical and time sensitive.
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.
Open source’s role in CONNECTing the public and private sector healthcare com...Brian Ahier
David Riley is the CONNECT initiative lead for the Federal Health Architecture (FHA) Program in the Office of the National Coordinator for Health Information Technology (ONCHIT). This is his presentation from OSCON.
ONC Releases 10-Year Vision To Achieve Interoperability in Health ITViSolve, Inc.
The Office of the National Coordinator for Health Information Technology recently released a vision document to achieve Interoperability in Health IT. Spread over 3, 6 and 10 years, the vision document highlights the pressing need to achieve interoperability among different Health IT systems.
We are publishing a draft of the technical standards of the Personal Health Records (PHR) component of the National Health Stack (NHS)!
As a refresher, these standards govern the consented sharing of health information between Health Information Providers (HIPs) - like hospitals, pathology labs, and clinics - and Health Information Users (HIUs) like pharmacies, medical consultants, doctors, and so on. The user’s consent to share their health data is issued via a new entity called a Health Data Consent Manager (HDCM).
The problem today is that the electronic health records listed in one app or ecosystem are not easily portable to other systems. There is no common standard that can be used to discover, share, and authenticate data between different networks or ecosystems. This means that the electronic medical records generated by users end up being confined to many different isolated silos, which can result in frustrating and complex experiences for patients wishing to manage data lying across different providers.
With the PHR system, a user is able to generate a longitudinal view of their health data across providers. The interoperability and security of the PHR architecture allows users to securely discover, share, and manage their health data in a safe, convenient, and universally acceptable manner. For instance, a user could use a HDCM to discover their account at one hospital or diagnostic lab, and then select certain electronic reports to share with a doctor from another hospital or clinic. The flow of data would be safe, and the user would have granular control over who can access their data and for how long. Here is a small demo of the PHR system in action.
The standards in the draft released today offers a high-level description of the architecture and flows that make this possible.
Addressing the Healthcare Connectivity ChallengeTodd Winey
In healthcare, information accessibility can impact the outcome of a medical decision, or the success of a bundled payment initiative. To ensure that the right information is available at the right place and time, healthcare organizations typically have used HL7® interface engines to share data among clinical applications. But the demands on healthcare information technology are changing so rapidly that these simple engines are no longer sufficient.
Microsoft Unified Communications – Role in Healthcare Service Improvement Whi...Microsoft Private Cloud
Unified communications (UC) broadly defines a highly integrated
communications environment that combines, or unifies, text, voice,
video, and data communications in innovative ways to provide process
and productivity improvement. It provides for real-time delivery of
communications based on the preferred method and location of the
recipient and facilitates the incorporation of all information sources
pertinent to the communication. The technologies to support UC can
include email, telephony, voicemail, instant messaging (IM), video,
Web conferencing, and short message service (SMS), which can be
brought together in various combinations in real time and coordinated.
The benefits of UC are amplified in those organizations in which the
workers are highly mobile and communication between them is both
critical and time sensitive.
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.
Open source’s role in CONNECTing the public and private sector healthcare com...Brian Ahier
David Riley is the CONNECT initiative lead for the Federal Health Architecture (FHA) Program in the Office of the National Coordinator for Health Information Technology (ONCHIT). This is his presentation from OSCON.
ONC Releases 10-Year Vision To Achieve Interoperability in Health ITViSolve, Inc.
The Office of the National Coordinator for Health Information Technology recently released a vision document to achieve Interoperability in Health IT. Spread over 3, 6 and 10 years, the vision document highlights the pressing need to achieve interoperability among different Health IT systems.
We are publishing a draft of the technical standards of the Personal Health Records (PHR) component of the National Health Stack (NHS)!
As a refresher, these standards govern the consented sharing of health information between Health Information Providers (HIPs) - like hospitals, pathology labs, and clinics - and Health Information Users (HIUs) like pharmacies, medical consultants, doctors, and so on. The user’s consent to share their health data is issued via a new entity called a Health Data Consent Manager (HDCM).
The problem today is that the electronic health records listed in one app or ecosystem are not easily portable to other systems. There is no common standard that can be used to discover, share, and authenticate data between different networks or ecosystems. This means that the electronic medical records generated by users end up being confined to many different isolated silos, which can result in frustrating and complex experiences for patients wishing to manage data lying across different providers.
With the PHR system, a user is able to generate a longitudinal view of their health data across providers. The interoperability and security of the PHR architecture allows users to securely discover, share, and manage their health data in a safe, convenient, and universally acceptable manner. For instance, a user could use a HDCM to discover their account at one hospital or diagnostic lab, and then select certain electronic reports to share with a doctor from another hospital or clinic. The flow of data would be safe, and the user would have granular control over who can access their data and for how long. Here is a small demo of the PHR system in action.
The standards in the draft released today offers a high-level description of the architecture and flows that make this possible.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
SURGICAL ANATOMY OF THE RETROPERITONEUM, ADRENALS, KIDNEYS AND URETERS.pptx
Improving Health It Interoperability
1. Strategies for Improving Health IT Architecture
Interoperability
WG:
Paul Aneja EA CoP
Paul Aneja John Fitzpatrick CDC EA CoP
Co-Chair Enterprise Architecture CoP Vish Sankaran ONC FHA
Sept 2, 2009 Craig Miller ONC NHIN
Draft Work in Progress Sondra Renly IBM Research
Paul.aneja@state.or.us Nancy Friedland IBM
Linh Le State of NY
2. Agenda Topics
What is Interoperability?
How interoperable are current health IT systems?
Key Health IT Interoperability Challenges
Benefits of Increasing Health IT Interoperability
Strategies for Improving Health IT Architecture
Interoperability
Break Out Groups
Report Out from Break out groups
Improving Interoperability through Effective Health IT Architectures 2
4. How do we define interoperability?
Improving Interoperability through Effective Health IT Architectures 4
5. What is Interoperability?
Interoperability generally refers to "the ability of two or more
systems or components to communicate, to exchange data
accurately, effectively, and consistently and to use the
information that has been exchanged….”
“In healthcare, the ability ‘to use the information that has been
exchanged’ means not only that healthcare systems must be
able to communicate with one another, but also that they must
employ shared terminology and definitions.”
Source: HL7 Coming to Terms Whitepaper
Improving Interoperability through Effective Health IT Architectures 5
6. How interoperable are current Health IT systems?
Do all health IT systems store the same information, the same
way (e.g. demographics)?
Can patients move between providers/doctors and with their
health history accessible?
How do Health IT systems exchange data today?
Do we have a common language that all business partners
health IT systems speak?
Interoperability between clinical and public health systems?
How is security and privacy of consumers and protected health
information managed across health IT systems?
…
Improving Interoperability through Effective Health IT Architectures 6
7. Why is Health IT Interoperability important?
Make improved health decisions based on all data
Improve exchange of health information between health IT
systems
Access information across different systems, sectors, platforms
Reduce cost and complexity
Enable future ready solutions
Continuity of care for patients
Improving public health situational awareness
Improving Interoperability through Effective Health IT Architectures 7
8. What are real-life examples of good interoperability?
Lets look the phone as an example
What makes phones interoperable?
Is it what material phone is made from?
Is it the features, ringer, dial pad?
Is it the shape, color?
Calling parties have to be in the same geographic area?
Is it the manufacturer?
Improving Interoperability through Effective Health IT Architectures 8
9. Key Health IT Interoperability Challenges
HIT is a extremely fast moving train with brand new concepts, architectures,
needs, etc.
Nature of “Enterprise” is changing – Clinical and PH and …
Interoperability is complex and not well understood
Difficult to coordinate across systems and organizations
What do we want to make interoperable? What is the scope of
interoperablity?
Siloed health it systems in different groups and programs
Data elements are not common across same type of Health IT systems
Coordinating security and privacy of health IT systems
Lack of coordinated standards in use by all HIE players
Document based vs messaging based architecture choices
Strategic architectural understanding and approach
Cross HIT governance is a challenge
Funding
Improving Interoperability through Effective Health IT Architectures 9
11. Interoperability Guiding Principles
Adopt and leverage national HIT Architectures
Adopt and leverage national HIT standards
Reusable Shared Services based on Services Oriented Architecture
(SOA) design principles
Architect/Design with interoperability as a key requirement from start
Create technology neutral architecture
Stronger governance of Health IT across health organization
“Enterprise Architect” role, to focus on common enterprise issues
Improving Interoperability through Effective Health IT Architectures 11
12. Levels of Health IT Interoperability
Different levels of Health IT Interoperability
1. Not interoperable
2. Within same health organization
3. Regional HIE
4. Statewide HIE
5. National HIE
6. International
Improving Interoperability through Effective Health IT Architectures 12
13. Public Health IT Systems Interoperability
Typical PH IT Systems
Immunization
Disease Surveillance
Vital Records
Lab Systems
Registries (Cancer, STD, TB, )
Environmental Health,
Lead,
…
There are number of common functions across health systems
Are PH IT Systems integrated with other Health systems?
How to improve interoperability of the PH IT systems?
Improving Interoperability through Effective Health IT Architectures 13
14. HIT Use Cases example
Improving Interoperability through Effective Health IT Architectures 14
15. Nationwide Health Information Network
Highly distributed: Patient
health information is retained at
the local health information
exchange level
Local autonomy: Each HIE
must make their own
determinations with respect to
the release of patient information
Focus only on inter-
organizational health
exchange: The NHIN does not
attempt to standardize
implementations of the NHIN
services and interfaces, only the
communications between HIEs
Use public internet: The NHIN
is not a separate physical
network, but a set of protocols
and standards that run on the
existing internet infrastructure
Platform neutral: The NHIN has
adopted a stack (web services)
that can be implemented using
many operating systems and
programming languages
15
Copyright 2009. All Rights Reserved. Effective Health IT Architectures
Improving Interoperability through 15
16. HIT Standards for Interoperability
Enterprise Health IT Architecture leverages HIT Standards for
number of reasons including
Creating a reusable architecture
Improve standardization
Increase future adaptability
Improve integration across HIT systems
…
Momentum and progress on HIT standards has increased
substantially
What are the “right” standards for what purpose?
Improving Interoperability through Effective Health IT Architectures 16
17. HIT Standards for Interoperability
Key Health IT Standards Organizations
HIT Standards Committee
HITSP
IHE
HL7
PHDSC
…
Improving Interoperability through Effective Health IT Architectures 17
19. HIT Standards for Interoperability
Structured Electronic Clinical Messaging Eligibility, Benefits Quality Measure
Data Exchange Documents HL7 v2.5.1 and Referrals Reporting
Standards HL7 v.3 CDA or Immunization & ASC Z12 v.4010A1,
CCD for summary rec Vaccination updates NCPDP Scrip v5.1 and CMS PQRI Registry
only: HL7 v2.3.1 CAQH CORE Phase I XML Spec
& II
Clinical Problems & Laboratory Tests Units of Measure
Vocabulary Procedures
PHIN VADS
Standards ICD 9 & ICD 10
LOINC UCUM
SNOMED CT
Cross Document Clinical • Electronic Health
Interoperability Sharing Record - Centric IS
Lab Reporting Patient Demographic
Specifications XDR.b Medical Summary Query •Exchange
Architecture &
& Profiles Emergency Referral Patient Identifier Harmonization
Cross Referencing
Communications SOA
Communication
Standards TCP/IP WS-* and REST
WSDL
SOAP
…
Improving Interoperability through Effective Health IT Architectures 19
20. Reusable Shared Services in Health IT
(using SOA)
Why do we have so many separate or silo systems?
And there are common functions/services in many of systems
Lets change the paradigm of building new health systems to
reusing shared services
Challenges:
What reusable services are needed for Health Information
Exchanges?
How can Service Oriented Architecture principles be applied
throughout the Enterprise Architecture?
Improving Interoperability through Effective Health IT Architectures 20
21. Reusable Shared Services in Health IT
(using SOA)
Here is a starting list of potential HIE reusable services…
HIE Immunization
PH Case Get
Enrollment Validation
Reusable Reporting Health Records
Shared Demographic
Services Service Patient
Authentication
Matching
Eligibility Secure
Check Personal Health Get Immunization Allergy Messaging
Record Update Records Check
What other Shared Services are needed?
Improving Interoperability through Effective Health IT Architectures 21
22. Privacy and Security
Support national privacy & security standards.
Create standards by which data can be shared and adopt one
set of clearly defined privacy standards.
Implement standardized measures to safeguard protected
health information (PHI).
Security & Access Control Authentication Identity Management Transport
Privacy HL7 v3 RBAC Kerberos Network Auth v5 LDAP XDS.b
SAML EUA End User Authentication Personal White Pages
WS-Trust v1.7
WS- Security
OASIS XACML (2015)
Challenges:
How many states have common Directory/LDAP that apps use?
Diversity of standards for security and privacy
Improving Interoperability through Effective Health IT Architectures 22
23. Health IT Architecture Interoperability Framework
EHR Biosurve PH Immuniz Newborn Emerge Personal
Health IT illance Case ation Screenin ncy ized
Reportin g Respond Healthca
Use Cases g er EHR re
National HIE National Health NHIN Connect
Information
Architecture Network
PH Case Immunization Allergy Get Secure
HIE Reusable Enrollment
Reporting Health Records
Validation Check Messaging
Shared Eligibility Personal Health Get Immunization Demographic Patient
Check Authentication
Services Record Update Records Service Matching
Structured Electronic Clinical Messaging Eligibility, Benefits and Quality Measure
Data Exchange Documents HL7 v2.5.1 Referrals Reporting
Immunization registries & ASC Z12 v.4010A1,
Standards HL7 v.3 CDA or Vaccination updates only: NCPDP Scrip v5.1 and CMS PQRI Registry XML
CCD for summary records HL7 v2.3.1 CAQH CORE Phase I & II Spec
Clinical Problems & Laboratory Tests Units of Measure PHIN VADS
Vocabulary Procedures
Standards ICD 9 & 10
LOINC UCUM
SNOMED CT
Access Control Authentication Identity Management Transport
Security & HL7 v3 RBAC Kerberos Network Auth v5 LDAP XDS.b
Privacy SAML EUA End User Authentication Personal White Pages
WS-Trust v1.7
WS- Security
OASIS XACML (2015)
Communications SOA
Communication
TCP/IP WS-* and REST
Standards WSDL
SOAP
…
HIE Infrastructure SOA PHRs Repository
HIT HIE Exchange solution
ESB Google, MS, WebMD, HIE Document Index
Infrastructure HIE Exchange
Services Registry HIE Document
HIE Adapters Repository
…
Improving Interoperability through Effective Health IT Architectures 23
24. Conference Sessions of interest
Interoperability showcase
Federal Health Architecture
PHDSC Service Oriented Architecture for Public Health
NAPHIT-PHDSC session Sept 2 Wed 5:30-8pm
Improving Interoperability through Effective Health IT Architectures 24
27. Lets Form into 3 Breakout Groups
Each Breakout Group to address:
Top 3 things to increase interoperability
Interoperability Top Challenges
Key Interoperability Solutions
3 Breakout Groups
Health IT Architectures
Health IT Standards
Shared Services in Health IT
Improving Interoperability through Effective Health IT Architectures 27
28. Breakout Groups Report Out
Improving Interoperability through Effective Health IT Architectures 28