Interoperability framework overview

Interoperability Framework

Overview

June 24, 2010

Presented by:

Douglas Fridsma, MD, PhD

Acting Director, Office of Interoperability & Standards

ONC

HIT Standards Committee

Goals of the Standards and Interoperability

Framework

» Move toward more “computational” implementation specifications (IS)

• Scalable processes

• Ability to develop tools to increase the efficiency of IS development and maintenance

• The importance of developing IS that are explicit and subject to less interpretation

» Link use cases and standards from inception to certification

• Keep the certification processes tightly linked to the standards and IS processes

• Support tool development for certification testing

• Develop the testing for compliance at the same time as developing the standards and IS

» Integrate multiple SDOs with different expertise across the process

• Transport packages

• Vocabulary

• Value sets

• Security

6/25/2010

Bottom up use case development within a top-

down coordination framework

NHIN Direct + Interoperability Framework = Focused Collaboration

CORE PRINCIPLES

Prioritization

Transparency

Engagement

Rapid Results

Focused

Collaboration

A Thousand

Flowers Bloom

Command

and Control

Low High

Participation

Lo

wH

igh

Focus

Bottom Up Innovation within a

Coordination Framework

Tools and Services(Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository, Testing Scripts, etc)

Use Case Development

and Functional

Requirements

Standards

Development

Certification

and Testing

Harmonization of

Core Concepts (NIEM

framework)

Implementation

Specifications

Pilot Demonstration

Projects

Reference

Implementation

Use Case Development and

Functional Requirements

» Example of a use case

• provider wants to send a referral to a specialist electronically

» Use case describes

• Services

• Standards (package)

• Business rules, trust, policies

That are necessary to satisfy the use case

The process should

» Engage a wide community in defining the use cases

» Focus on solving a real problem

• Determines scope

• Able to “test” if the use case solves the problem

• Prevents “analysis paralysis”

• Does not model in the abstract

• Open, transparent process

» Establish a “use case steward” to shepherd the use cases through the entire process

» Output is a clear description (in a computable form) that describes the standards, services and policies necessary to describe the use case

Use Case Developmentand FunctionalRequirements

Standards Development

Certificationand Testing

Harmonization ofCore Concepts (NIEM

framework)

Implementation Specifications

Pilot Demonstration Projects

Reference Implementation


Tools and Services

(Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository, Testing Scripts, etc)

Harmonization of Core Concepts

» Need to have a strong harmonization framework that spans different standards organizations

• XML/UML computational descriptions of the use cases

• Strong governance and transparent processes

• Use-case driven (bottom up) with top down coordination

» Harmonization processes need to describe

• Standards• Services• Policies

In standard ways





framework)





framework)

» Multiple use cases might have overlapping standards, services or policies

• E-prescribing and adverse event reporting

• Clinical care summary and quality reporting

• Laboratory data exchange and clinical decision support

Tools and Services


Harmonization of Core Concepts

» Standards harmonization

• Leverage best practices

• Use the NIEM processes

• Create explicit data exchange package that describe the data elements, vocabularies and value sets

» Service harmonization

• Information model

• Services description

• Conformance description

• Governance (business rules) descriptions

» Policy descriptions

• Harmonization of policies is a challenge





framework)





framework)

» Three parts to harmonization

• Description of the standards

(the data that is exchanged)

• Description of the services

(the functions that will be

supported in the exchange)

• Description of the policy

(trust, business rules, etc)

Tools and Services


What is the NIEM process?

» National Information Exchange Model

» Started as a DoJ initiative, but the processes have been generalized

• Supported data integration and reporting for Recovery.gov

• Used by HHS to support child and family services

• Recommended by OMB as best practice

• Used by state and local governments





framework)




Tools and Services



framework)

Patient

Discovery

Quality

reporting

Discharge

Summary

Provider

address lookupFuture

Domains

E-prescribingLab data

exchange

PHR

exchange

Patient summary

Child and

Family

Services

Common

Core

What is the NIEM framework?

» A common core of concepts, explicitly defined, that are shared across different use cases or domains

» Naming and modeling conventions that allow different groups to work independently but harmonize the work together

» Based on the ISO-11179 metadata standard used by the NCI, NLM, and standards organizations.

6/25/2010

Patient

Discovery

Quality

reporting

Discharge

Summary

Provider

address lookupFuture

Domains

E-prescribingLab data

exchange

PHR

exchangePatient summary

Child and

Family

Services

Common

Core


framework)


» Gaps in existing standards

• Data package

• Value sets

• Services

» Can be identified as part of the

use case development and

harmonization process

» Work with SDOs (NLM, HL7

etc) to fill in gaps

» Allows the standards work to

proceed in parallel with

development of the

implementation specifications





framework)




StandardsDevelopment

Tools and Services



» If the standards, services and

policies are the ingredients,

then the implementation

specification is the recipe

» Packaged together to support

use cases

» Guides development of

reference implementation

» Interim Final Rule requires

creation of Implementation

Specifications where they don’t

exist





framework)




ImplementationSpecifications

» An implementation

specification becomes a

explicit description of the

• Standards

• Services

• Policies

» That conform to adopted

standards and have sufficient

detail to be implemented

Tools and Services



» Specification must be tested to

make sure they can be

implemented

» Can be used by others to help

guide their own implementation

or find problems with

specifications

» Encourages feedback to ONC





framework)





» Example: CONNECT

software could potentially be

the reference implementation

of NHIN specifications and

standards

Tools and Services



» Reference implementation in

use by stakeholders

» Confirms use case is being

supported

» ONC should provide

coordination of pilot

demonstrations





framework)





» NHIN Trial Implementations

» NHIN Limited Production

Exchange

» NHIN Direct Project

Tools and Services


Certification and Testing

» Culmination of prior activities

» NIST can help create test

harnesses to ensure

conformance with

specifications





framework)





NIST Conformance tools

Tools and resources for

certification processes

Tools and Services


Tools and Services

» Make the process as

automated and self-serve as

possible

» Leverage tools & services in

future efforts

Tools and Services






framework)




Bottom Up Innovation within a

Coordination Framework

Tools and Services(Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository, Testing Scripts, etc)

Information Model,

Services, and

Value Sets

Harmonized/

Implementation

Specification

Integration Testing

and

Implementation

Reference

Code Set

Use Case Development

and Functional

Requirements

Standards

Development

Certification

and Testing

Harmonization of

Core Concepts (NIEM

framework)

Implementation

Specifications

Pilot Demonstration

Projects

Reference

Implementation

S&

I and H

ITS

C

Activitie

s

NH

IN D

irect

Activitie

s

J J A S O N D J F M A M J J A S O N

Tools and Services






framework)






HIT

PC

Activitie

s

HITPC P&S Tiger Team Policy

Framework

HITPC + HITSC

Specification Policy Review

HIT Standards Committee ReviewNHIN Inclusion

Evaluation

Other Standards

Governance

Evaluations

NHIN Direct Example

Interoperability framework overview

Technology

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