Automate Blue Button Initiative Push Workgroup Meeting

November 26, 2012

Meeting Etiquette

• Remember: If you are not speaking, please keep your phone on mute

• Do not put your phone on hold. If you need to take a call, hang up and dial in again when finished with your other call o Hold = Elevator Music = frustrated speakers and participants

• This meeting is being recordedo Another reason to keep your phone on mute when not

speaking• Use the “Chat” feature for questions, comments and items you

would like the moderator or other participants to know.o Send comments to All Panelists so they can be addressed

publically in the chat, or discussed in the meeting (as appropriate). From S&I Framework to Participants:

Hi everyone: remember to keep your phone on mute

All Panelists

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Agenda

Topic Time Allotted

Announcements, Timeline 3 minutes

Patient Portal Flow 10 minutes

EMR Flow 10 minutes

Open Question: Payload 15 minutes

Open Challenge: Transmit to any Direct Address 20 minutes

Next Steps / Reminders 2 minutes

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Announcements and Reminders

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• Meeting Reminders– Push Workgroup Meetings are Mondays from 2:00 – 3:00 pm Eastern.– Direct Connect-a-Thon (December 6, 2012)– ABBI Face to Face (December 11, 2012 from 2:30-4 pm)– The next Community Meeting will be held as needed. – Meeting information is on the Automate Blue Button Wiki Page: http://

wiki.siframework.org/Automate+Blue+Button+Initiative

• Community Homework– Provide comments and feedback on the Push Implementation Guides:http://wiki.siframework.org/Push+Implementation+Guidance+Comments+and+Feedback– Comment period ends Wednesday, November 28th.

Looking ForwardABBI Schedule• November

– October 22- November 19: Drafting and comment period on ABBI Implementation Guide (Part 1: Send via Direct + Content)

– Nov 19th : BEGIN Comment Period Round 2 on ABBI Implementation Guide (Part 1: Send via Direct, Content) – 26th : Discuss Comments in workgroup calls– 28th : END Comment Period on ABBI IG (Part 1)

• December– 3rd : Review Implementation Guide Comments in Workgroup Calls and Finalize Guide– 6th : ABBI Participates in Connect-a-thon– 10th : “Public Release” of ABBI Implementation Guide (Part 1)– 11th : ABBI Participates in Town Hall @ ONC Annual Meeting– 21st : BEGIN Comment Period on ABBI Implementation Guide (Part 2: Send via Email, Payer Content, and Developer

Toolkit)• January

– ~ 10th: END Comment Period on ABBI Implementation Guide (Part 2)– ~ 15th : Release ABBI Implementation Guide (Part 2)– All of January: Testing Period; Identify and Respond to Reference Implementations

• February– Testing Period; Identify and Respond to Reference Implementations

• March– Complete Testing Period– HIMSS: Showcase ABBI Implementations – Release Final Automate Blue Button v2 Implementation Guide (Part 1 and Part 2 listed above)

Flow 1: Patient Portal

1. Patient logs into portal

Flow 1: Patient Portal

2. Patient clicks on “Share with Direct”

Flow 1: Patient Portal

3. Patient reads and accepts transmit terms

Flow 1: Patient Portal

4. Patient enters Direct address and selects transmit frequency

Flow 1: Patient Portal

5. Flow Complete

Flow 1: Patient Portal

1. Patient logs into portal 2. Patient clicks on “Share with Direct”

3. Patient reads and accepts transmit terms

4. Patient enters Direct address and selects transmit frequency

Flow 2: Provider

Flow 2: Provider

Flow 2: Provider

Flow 2: Provider

Open Question: Payload

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• Push– Multi-part MIME– application/xml+ccda– Message Body:• This message was sent by [Data Holder Name] at the

request of [Patient Name] to [Direct Address]. • (Optional) It includes: [List of Files].

– Structured Version?• Data Holder Name• Patient Name• Direct Address• Array of Files

Open Challenge: Sending securely to any address

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• Transmit will have two approaches• When a transmission occurs, the HISP will pull down

the organizational level certificate and self-signed certificate– Org: (Verisign example.org)– Self: (Example.org someone@example.org)

• (1) If the self-signed certificate matches a trust anchor that has already been loaded into the HISP, it will send the message that way.

• (2) If the self-signed cert is not in the system, it will use the organizational cert to encrypt the message. It will also include the destination address in the payload.

Open Challenge: Sending securely to any address

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• 3rd Party Applications / Locations– Need to exchange their anchors– Need to make their self-signed certificates

discoverable via DNS and LDAP– Need to obtain a SSL certificate from CA– Need to make that org certificate discoverable via

DNS and LDAP– Need to parse message to ensure it was delivered

to right location

Next Steps / Reminders

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• Next Steps– Provide Feedback to revised Implementation Guide– Focus on Workflow

• Meeting Reminders– Next PUSH Workgroup Meeting is Monday, December 3rd, 2012 @ 2:00 pm

Eastern. – The next Community Meeting will be held as needed. – http://wiki.siframework.org/Automate+Blue+Button+Initiative

• Upcoming Face-to-Face Opportunities:– Dec 6th – Direct Connect-a-thon which will include an ABBI opportunity – Dec 11th – ONC Annual Meeting – ABBI Town Hall

• For questions, please contact your support leads– Initiative Coordinator: Pierce Graham-Jones (pierce.graham-jones@hhs.gov)– Presidential Innovation Fellow: Ryan Panchadsaram (

ryan.panchadsaram@hhs.gov)– Project Manager: Jennifer Brush (jennifer.brush@esacinc.com)– S&I Admin: Apurva Dharia (apurva.dharia@esacinc.com)

BACK-UP SLIDESABBI Push

Pre-Discover

y

Discovery

Reference Implementatio

ns

Agreed and voted on charter, including Scope Timeline Deliverables

Identified priority implementation options: Transmit requirement of MU Stage 2 (from V/D/T requirement) + automation Email + file encryption also discussed as option for PUSH

Wrote draft use case for two V/D/T + automation Write draft use case for Email (and/or Payer) option Identified issues related to V/D/T + automation Write policy FAQ document to support PUSH options Write draft implementation guide for V/D/T + automation Write draft implementation guide for Email

Identify 1-2 V/D/T implementations that can serve as reference implementations for our group Identify 1-2 vendors / data holders willing to work on Automated Push reference implementations

Implementation Guidance

Implementations

Refine use cases based on reference implementations Refine implementation guide based on reference implementations

3-6 full implementations that reflect implementation guidance

PUSH Current Status

21

WG Launch(09/17)

Nov-12

DiscoveryS&I Framework Lifecycle

Sep-12 Mar-13

Pilot & Implementation Guidance Implementation

Oct-12 Dec-12 Jan-13 Feb-13

FinalizeImplementation

Guidance for Direct

Use Case 1 Definition (DIRECT @ Physician’s Office)

Use Case 2 Definition (DIRECT via Patient Portal)

Use Case 3 Definition (Email)

UC3 Implementation Guidance for Email

Full implementations with providers /

Payers

Timeline

Outstanding Issues

Pilots Identified & On Track

Next Steps Status

PUSH Dashboard

Draft Implemen

tation Guidance

Reference Implementations using

Direct

Reference Implementations using

Email

PushWorkgrou

p

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Write policy FAQ document to support PUSH options Write draft implementation guide for V/D/T +

automation Write draft implementation guide for Email Identify V/D/T implementations that can serve as

reference implementations for our group Identify vendors / dataholders willing to work on

Automated Push reference implementations

PUSH Current Deliverables

Implementation Guide

PushWorkgrou

p

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http://wiki.siframework.org/file/view/ABBI+IG+-+Transmitting+Data+Using+the+Direct+Protocol+2012-11-15.docx

http://wiki.siframework.org/file/view/ABBI+IG+-+Receiving+Health+Data+Using+the+Direct+Protocol+2012-11-15.docx