© 2005 ibm corporation laying the foundation for the nationwide health information network (nhin)...

© 2005 IBM Corporation

Laying the Foundation for theNationwide Health Information Network (NHIN)

IBM Consortium - Prototype Architecture Infrastructure

February 15, 2006

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NHIN Architecture Prototype: Key Facts

Announcement of Awardees on November 11, 2005 – Work will help create the foundation of the Nationwide Health

Information Network.

– RFI November 15, 2004 followed by RFP June 6, 2005

– Design and implement a standards-based network prototype over the coming year

– Develop and evaluate prototypes of a NHIN architecture that maximize use of existing resources to achieve interoperability among Healthcare Applications – particularly EHRs.

– Demonstrate the solution in 3 marketplaces / communities

– 12 month duration with option period to increase participation and for further demonstration.

The NHIN Prototype – Key Facts

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NHIN Architecture Prototype : Key Facts– Four Major Consortia were Awarded Contracts – Led by :

– IBM

– Accenture

– CSC

– Northrop Grumman

– Cooperative and Collaborative Approach

– Between Four Awarded Consortia

– With Other HHS Partners

– Health Information Technology Standards Panel (established by ANSI)

– Certification Commission for Health Information Technology (CCHIT)

– Health Information Security and Privacy Collaboration (established by RTI and National Governor’s Association)

The NHIN Prototype – Key Facts

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Team IBM Core Team

– Project Executive: Ginny Wagner, PMP

– Business Lead: Richard Steen

– Project Manager: Russell Scott

– Chief Architect: Casey Webster

– Consulting Architect: Kevin Julier

Small Business Partners

Argosy Omnimedia Business Innovation

HMS Technologies IDL Solutions

Ingenium VICCS

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NHIN Context The NHIN Prototype – Context

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Community Partners Fishkill, NY

– Taconic Health Information Network & Community (THINC)

– Dr. John Blair

– 2,300 physicians supporting 700,000 patients

– Shared data using Healthvision Research Triangle, NC

– North Carolina Healthcare Information and Communications Alliance (NCHICA)

– Holt Anderson

– Competitive, high-tech urban environment Rockingham County, NC

– Also members of NCHICA

– Rural environment with NC and VA patients

– Small, competitive practices and hospitals

The NHIN Prototype – Communities

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Architectural Principles Drive and conform to standards

– Instantiation of IHE interoperability framework (XDS, PIX, PDQ, ATNA & CT profiles)

– IHE-compliant cross-domain data search & retrieval

– PIX inter-community patient identification cross-referencing

– Hardware & software vendor agnostic (J2EE, JDBC, JMS, EJB)

– XML, CDA, SAML, …

Community-Centric– XDS Document Repositories aggregate and normalize clinical data across a

community and can be distributed within that community

– Each community has an XDS Document Registry that indexes and tags community data and supports the inter-community NHIN interface

Comply with security & privacy w/o sacrificing usability or research value– Anonymous/pseudonymous data that can be re-identified as needed

– Other data aggregates (registries, biosurveillance, outcomes analysis, quality of care) Practical

– Scalable and cost-effective at every level of practice

– Point-of-care performance is critical to adoption

The NHIN Prototype – Architectural Principles

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High-Level Community Architecture

NH

IN Interface

Security and Privacy

Clinicians

XDS Registry*

Portal

HCN Adapters

Auditing

PIX/PDQ MPI* Data Transforms

TerminologyDocument Search/Retrieve

Patient Consent Biosurveillance

BetweenCommunities

Request Response

QoSSecurityAuditingLogging

Critical Data*

PIX/PDQData*

Patients

Other Components

IBM IHE Components

* 1 per community

KEY

CommunityXDS

Documents

The NHIN Prototype – Community Architecture

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Conceptual Architecture for the NHIN PrototypeThe NHIN Prototype – Conceptual Architecture

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Initial “Community” Use Case Areas

Domain: Biosurveillance– Use Case Area: emergency room and lab data reporting

Domain: Consumer empowerment– Use Case Area: registration summary and medication

history

Domain: Electronic Health Record– Use Case Area: accessing lab results and interpretations

The NHIN Prototype – Use Cases

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DRAFT ONC NHIN High Level Deliverables Schedule 2006

NHIN Deliverable Other Target DateInitial Submission of three use cases by consortia

ONC -> Community January

Proposed high-level standards ONC -> HITSP February

Community Endorsed Use

cases

NHIN Consortia and others March

Proposed functional requirements Harmonization April

NHIN Stakeholder Forum #1

CCHIT, HITSP, others May

Implementation guide / integration profile needs Harmonization June


HITSP, CCHIT, others July

Security and privacy models Harmonization September


HISPC, HITSP, CCHIT October

Proposed revenue & cost models Harmonization October


November

Documentation of architecture ONC November

Prototype ONC December

The NHIN Prototype – Schedule

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Next Steps … I encourage you to visit the IHE Interoperability Showcase

Peds … – See what has been done in terms of making this stuff real

Contact me (Kevin Julier) or Casey Webster with any questions

– [email protected]

or

– [email protected]