Quick Links

DS4P Pilots

Feedback Welcome

We value your input!
Have a suggestion or idea for the initiative wiki? Send an email the Project Manager.
Need help using the Wiki? Send an email to Wiki Admin/Support.

Edit SidebarRight


The Pilot involves the exchange of simulated Electronic Health Records (EHR) between large healthcare providers using Nationwide Health Information Network (NwHIN) Information Technology (IT) standards. Each access request over the simulated NwHIN Exchange (also called eHealth Exchange) will be decided in real time based on computable policy that includes privacy metadata. Patient consent directives (PCD) will be included in the evaluation of the access request. The Pilot will explore three aspects of this exchange:
How is the PCD correlated with the patient identity;
How is the PCD retrieved for use in the access control decision; and
How is the consumer informed of the request and access control decision.

Healthcare consumers currently do not have the ability to review remote electronic requests on the NwHIN Exchange for their Protected Health Information (PHI) or learn the outcome of those requests. The Pilot will add transparency to the exchange of PHI released by the consumer's provider organization to requesting organizations. Further, the Pilot will explore how subsequent requests made to requesting organizations (3rd party requests) can be reported to consumers. Currently there is no standardized way consumers can review the effect of their PCD on requests for their EHR. The goal of the pilot is to present a secure, scalable solution that allows consumers to evaluate if their PCD is operating as they planned.

In addition, transparency in access requests may allow consumers to identify possible medical identity theft or cases of mistaken identity that could impact their subsequent treatment. The outcome of the Pilot process will provide a much-needed solution that will protect consumers from possible financial loss and improve patient safety. The Pilot will also provide technical solutions that could be used to meet increasing privacy demands by patients and applicable laws.

Technical approach

We propose development of a data model and workflow that supports centralized storage and retrieval of PCD from a repository consistent with the Data Segmentation for Privacy Use Case document and current health IT standards. Pilot members will select a mechanism that reports access requests to consumer accounts at the repository. The mechanism will also allow reporting of third party requests for consumer PHI to the repository and reduce consumer to PCD correlation errors.

The work will expose gaps in extant standards and provide a foundation for proposing additional standards required for widespread NwHIN adoption. Particular emphasis will be given to exchanged privacy metadata and any requirement for additional privacy metadata identified in the pilot. The outcome of the Pilot will be a Reference Implementation (RI) that will provide evidence-based artifacts for evaluating the work and relevance to current exchange systems.


This pilot will address:
• Reduced patient correlation errors
• Exchange of metadata identifying repository location and credentials
• Patient identity and medical fraud
• Secondary use of PHI
• Greater patient awareness of access to their PHI

Goals are to:

• Exchange and enforce privacy metadata to ensure proper policy-based disclosure and redisclosure of PHI
• Allow patients to authenticate to their provider through their PCD repository, establishing the EHR access request reporting path and reducing patient collation errors
• Accept and display reports from information owners on access control decisions for requests for the patient’s PHI
• Create a token passing scheme that facilitates secondary use reporting
• Demonstrate dynamic reporting of access to a patient’s PHI and their ability to change their PCD using their PCD central repository

Stakeholders & Points of Contact

Jericho Systems
HIT Program at UT Austin

Demonstrated Standards

This pilot will demonstrate:
  • IHE XDS.b
  • HL7 Consent Directive DSTU

Ecosystem Diagram


Pilot Project Timeline

Target Date
Responsible Party
Kick off and Logistics
February 18, 2013
Jericho Systems
Basic Infrastructure
March 25, 2013
AuthN via Repository
May 25, 2013
Reporting Capability
July 25, 2013
September 25, 2013

Anticipated Resources

Success Metrics

• Exchange and enforcement of privacy metadata (e.g. refrain, POU, sensitivity, confidentiality)
• Exchange of PCD location and credential metadata
• Exchange of access reporting information to patient
• Exchange and enforcement of updated PCD

Reference Materials

Jericho/UT-Austin Pilot IG 2013-11-12 (pdf)
Implementation Guidance for Jericho/UT-Austin Pilot (Approved)
Jericho/UT-Austin Pilot IG 2013-11-04 (docx)
Implementation Guidance for Jericho/UT-Austin Pilot

Initiative Contacts

Contact Information
Johnathan Coleman
Initiative Coordinator
Julie Chua
ONC Sponsor
Zachary May
Project Manager, RI/Pilot Lead
Amanda Nash
Standards/Harmonization Lead
Standards Development Support Team Lead
Edit Contacts