HIT STANDARDS COMMITTEE

DRAFT:
S&I Framework
Principles and Processes

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S&I Framework

KICK-OFF

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S&I Mission

» Promote a sustainable ecosystem that drives increasing

interoperability and standards adoption
» Create a collaborative, coordinated, incremental standards
process that is led by the industry in solving real world
problems
» Leverage “government as a platform” – provide tools,
coordination, and harmonization that will support interested
parties as they develop solutions to interoperability and
standards adoption.

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ONC Standards and Interoperability Framework

Standards Pilot Demonstration

Development Projects
(TBD) (Lockheed Martin)

Use Case Development

Harmonization of Implementation Reference Certification
and Functional
Core Concepts Specifications Implementation and Testing
Requirements
(Deloitte) (Deloitte) (Lockheed Martin) (Stanley/Deloitte)
(Accenture)

Tools and Services

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

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Standards and Interoperability Organizational
Structure

Standards and Interoperability

Standards National Health Certification FHA

Information Network
and Testing
Standards NHIN Teams Certification FHA
Teams Team Teams
CONNECT
Use Cases Architecture Certification (TBD)
(Accenture) (Stanley/Deloitte)
Reference
Standards Implementations
Development (Lockheed Martin) Test
Infrastructure
(TBD) (Stanley/Deloitte)
Emergent Pilots
(Lockheed Martin)
Harmonization
(Deloitte)
Tools
(Stanley)
Spec Factory
(Deloitte) Operations
(Stanley) 5
What is an IEPD?

» An Information Exchange Package Documentation (IEPD)

is a collection of artifacts that describe the construction and
content of an information exchange
• Developed to provide the business, functional, and technical details
of the information exchange through predefined artifacts
• Created with a core set of artifacts in a prescribed format and
organizational structure to allow for consistency
• Designed to be shared and reused in the development of new
information exchanges through publication in IEPD repositories
• IEPDs contain design specifications for an information exchange
but may not include supplementary information such as
implementation decisions.

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The IEPD Artifacts

IEPDs contain both Scenario

Planning
required and
recommended
artifacts Analyze
Requirements

Required : Bold
Map & Model
Recommended : Italic

Note: Best Build &

Validate
practices for most
organizations
Assemble &
include many of the
Document
optional artifacts
listed here
Publish & No required artifacts. Publish the IEPD to a
Implement repository and implement the exchange
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S&I NIEM Harmonization Strategy

Human
Services

» ONC’s Office of Interoperability and Standards is building a Health Information Exchange

Model (NIEM Health) that is harmonized with NIEM
» Health and Human Services petal to serve as bridge between NIEM and NIEM Health

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S&I NIEM Process Harmonized
Participants S&I Development Phases
Capability Capability Construction Release &
Formulation Elaboration Publication
Analyze Build & Assemble & Pub. &
NIEM Lifecycle Scenario Planning
Requirements
Map & Model
Validate Document Impl.

Use Case
Development

Harmonization

Spec
Development

Reference Impl

Cert &Testing

Health
Community

S&I Governance
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 Addressing Challenges for the Health Information
Exchange Model
Challenge Approach
Existence of disparate health information Map exchange requirements to existing standards
exchange standards and specifications and & specifications and address any gaps,
implementation approaches duplications, or overlaps

Harmonization and management of several Leverage existing vocabulary repositories (e.g.

well-established, large vocabularies for PHIN VADS), coordinate with Unified Medical
semantic interoperability Language System (UMLS), and collaborate with
standards development organizations

Usability of existing HIT exchange protocols Use NIEM processes and adapt supporting tools
and specifications to create computable, useable implementation
specifications

NIEM only addresses data content, but Adapt structure and content of S&I IEPD to
transaction behavior and security provisions incorporate transport and security aspects of
are necessary for health information exchange
exchange

Compatibility of S&I IEPDs with existing Develop and adapt NIEM and health information
NIEM infrastructure and tools, as well as technology tools and framework to support NHIN
existing health information exchange goals 10
protocols
Requirements for a Model Centric Approach

» The modeling approach used by the S&I Framework must

• Provide traceability from Use Case and Requirements
through to one or more implementations
• Provide semantic and syntactic modeling constructs to
support defining the information and behavior that are
part of exchanges
• Support the need to harmonize with existing standards
defined at different levels of abstraction
• Be adoptable by different organizations
• Be able to integrate into NIEM process

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Model-Centric Solution - MDA

» Base S&I Framework modeling on the 3 OMG/MDA model

abstractions.
• Computational Independent Model (CIM)
• Platform Independent Model (PIM)
• Platform Specific Model (PSM)
» Define a mechanism to show traceability from Use Cases and
Functional Requirements through to technical bindings defined in a
PSM.
» Define a flexible modeling foundation by which different types of
specifications can be defined.
» Provides ability for multiple technology bindings for the same set of
logical specifications (multiple PSMs)

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Model Centric Solution - NIEM

S&I Activities NIEM Processes and Artifacts Specification Models

Use Case Business
Development Vision Document,
Scenario Planning Processes, Use
and Functional Process Model
Cases
Requirements

CIM
Business Rules, Use Case Model,
Harmonization of Analyze Business Interaction Model,
Core Concepts Requirements Requirements Domain Model

Exchange Content
Implementation Map and Model
Model, Mapping Behavior Model
Specifications
Document Domain Model PIM

Exchange
Reference
Build and Validate Schema,
Implementation
Subset/Constraint
and Pilots
Schema,
Web Services
Schema and WSDL
PSM

Assemble and Main Document,

Certification and Document IEPD Catalog,
Testing IEPD Metadata,
Sample XML

Publish and
Implement 13
Prioritization and Backlog Lists

Strategic
Priorities

Operational
Priorities

“Day to Day”
Priorities within
each functional
team

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What’s Next

Pilot
Standards
Demonstration
Development
Projects

Use Case
Harmonization of
Development Implementation Reference Certification
Core Concepts
and Functional Specifications Implementation and Testing
(NIEM framework)
Requirements

Scenario
Planning
NIEM IEPD Lifecycle

» Create a NIEM Health standards harmonization process and governance framework

» Establish roadmap for existing NHIN standards, MU harmonization, and non-MU health information exchange
specifications
» Establishes a repeatable, iterative process for developing widely reusable, computable implementation
specifications
» Establishing the tooling and repositories needed
» Establishing the practices and guidelines for modeling
» Enables semantic traceability so that useable code can be traced back to original requirements and definitions
» Promotes transparency and collaboration from broad range of health stakeholders

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S&I Framework

CURRENT LESSONS

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Lessons Learned: NHIN Direct

High

» Consensus Driven Process

Focused » Open Collaboration
Command Collaboration
and Control » Established core guiding
Tr Cla principles
ad ss
Focus e- ic » Driven by business needs and
O
ff
elaborated use cases
A Thousand » Real world pilot
Flowers Bloom
implementation
» Establish executive
Low

Low High
sponsorship and workgroup
leads
Participation

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Lessons Learned: Eligibility and Enrollment

High

» Dedicated resource(s) to drive

Focused project and decision making
Command Collaboration
and Control
» Clearly defined problem
statement at project initiation
Tr Cla
ad ss
Focus e- ic » Define expectations for desired
O
ff artifacts
A Thousand » Promote community
Flowers Bloom enthusiasm
» Leverage tools to increase
Low

Low High efficiencies

Participation

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S&I Framework

ISSUES TO DISCUSS

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Issues and Challenges (1)

Issues and Challenges

HITSC HITPC
» How and when do we get input from
other stakeholders including those
Coordination outside of meaningful use?
Priority Setting » VLER
Evaluating Artifacts » Federal partners
» Other stakeholders
» How do we foster multiple working
S&I Framework groups and create a unified view of
Sustainable Operations priorities?

Shared Infrastructure

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S&I Framework Challenges (2)

How do we create simple, easy to implement specifications

that will drive adoption?
» How do we facilitate access to SDO standards for providers and support sustainable business models?
• Engaging the SDO community
• Developing a “one stop shop” for implementation specifications
» How do we foster community and industrial participation to support balanced representation and diverse
priorities?
• Identifying champions for S&I lifecycle initiatives
• Engage communities throughout S&I Framework
• Identifying demonstrable pilot programs
• Engaging and incentivizing volunteers from existing community

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S&I Framework Open Questions cont.

» What are the appropriate interface points with HITSC through S&I Framework lifecycle?
• Establish priorities, approve implementation specifications,
• Identifying appropriate decision makers at S&I control points
• Identifying appropriate roles and participants in the governance of S&I Framework
» How do we identify and select tools as shared resources that foster collaboration?
• Establishing and adhering to agreed upon modeling conventions
• Tools to support artifact lifecycle management and dissemination
» How do we extend NIEM to accommodate needs of health care domain?

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 S&I Framework Priorities

Prioritization needs to accommodate broad stakeholder needs, account

for breadth and depth of available expertise, and support a long term
growth strategy

» What should our priorities be for the next six months, twelve months, twenty-four
months? From among…
• Meaningful Use Stage 1
• Meaningful Use Stage 2 & 3
• NHIN Exchange
• NHIN Direct
• Health Care Reform
• VLER
• New use cases (lab, pharmacy, content specifications)

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