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DS4P Pilots



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Overview

This pilot will design, develop, test, and release to production solutions that implement the first 3 scenarios of the DS4P use cases, including:
  • Scenario 1 - User Story 1 – 42 CFR Part 2 Push / Share All / Partial
  • Scenario 2 - User Story 1B – 42 CFR Part 2 Pull between providers / Share All / Partial
  • Scenario 3 - User Story 1C – HIO Repository & Consent Repository
The enhancements to the various HIE and EHR solutions used in this pilot will focus on:
  • Ensuring that all data is correctly tagged in the payload and the protocols used to transport the payload,
  • The consent directive follows the data in transit, and
  • The receiving HIO or EHR can properly enforce the policies associated with the sensitive nature of the data received.
The solutions will be implemented with two different groups across the country. The referral network in the Tampa Bay will implement the first two scenarios, managing the direct push or pull of information between the various organizations involved in the coordination of care of an individual. The Kansas HIE (KHIN) along with behavioral health providers in their network will implement scenario 3, introducing the registry and repository model to the pull of information. Each of these groups will manage restricted data associated with programs regulated by 42 CFR part 2 and ensure that all requirements of this regulation are met including the redisclosure rules.

Technical approach

  • A standards based approach to the tagging, transmission, and security will be used throughout the solution
  • A SOA based infrastructure will be utilized to manage the integration between all of the organizations
  • Agile design and development between all organizations involved

Objectives

The 3 main objective of this pilot, as stated above, and relating the to 3 user stories are:
  • Ensuring that all data is correctly tagged in the payload and the protocols used to transport the payload,
  • The consent directive follows the data in transit, and
  • The receiving HIO or EHR can properly enforce the policies associated with the sensitive nature of the data received.
Along with this, the impact of each feature will be measured for the complexity of the implementation whether it is in the EHR or in the HIE registry and repository. This will inform the efforts required in the larger HIT community to implement the various changes.

All of the integration efforts will be based on existing standards or those developed as part of the DS4P initiative. Key standards used in this process will be the Direct Project, XDS.b, C32 CCD and the CDA, XACML, and SAML.

Phase 1 (Production - January 2013)

Scenario 1 - User Story 1
42 CFR Part 2 Push / Share All / Partial
Scenario 2 - User Story 1B
42 CFR Part 2 Pull between providers / Share All / Partial

Phase 2 (Pilot Release - January 2013)

Scenario 3 - User Story 1C
HIO Repository & Consent Repository

Phase 3 (Production Release - February 2013)

Scenario 3 - User Story 1C
HIO Repository & Consent Repository

Stakeholders & Points of Contact

Netsmart
Bill Connors
Senior VP, General Manager, Behavioral Health
801 Warrenville Rd.
Suite 350
Lisle, IL 60532
Role: Project Sponsor

Matthew Arnheiter
VP, Innovations
4950 College Boulevard
Overland Park, KS 66210
Role: Lead Technical Architect

KHIN
Laura McCrary, Ed.D
623 SW 10th Ave.
Topeka, KS 66612
Role: HIE Sponsor


Demonstrated Standards

  • Payload
    CCDA, C32, PDF
  • Transport Protocols
    DIRECT, XDR, XDS
  • Security
    SSL, PKI, SAML
  • Privacy Consent Policies
    42 CFR Part 2
  • Consent Standards
    XACML

Ecosystem Diagram

Pilot Project Timeline


Anticipated Resources

  • Netsmart
    Matthew Arnheiter: Lead Architect
    Mark Gromowsky: Lead Integration Engineer
    KHIN
    Informatics Corporation of America (ICA)
  • Infrastructure
    Netsmart CareConnect: Cloud Based Integration Engine
    Netsmart myAvatar: MU1 Certified EHR
    KHIN HIE utilizing ICA

Success Metrics

The goal is to provide an open standards based solution to exchange PHI information where the consent directive follows the data and is understood at each layer of the exchange, i.e. EHR and HIE. We are also testing the impact these standards have on an EHR, balancing the amount of change with a complete solution to properly secure sensitive information. Success metics for the pilot include:
  • Automated Data Tagging of the CCD with Data Confidentiality at the segment level
  • Demonstrate compliance with 42 CFR Part 2 prohibition against re-disclosure notification
  • Demonstrate segmentation of 42 CFR Part 2 protected information and the proper mechanisms in the EHR to not re-disclose the information without consent.
  • Implement the security and privacy metadata in the XD* envelope

Reference Documents

Document
Description

Netsmart DS4P Proposal Presentation to DS4P community on 11/28/2012.

Initiative Contacts

Name
Role
Contact Information
Johnathan Coleman
Initiative Coordinator
jc@securityrs.com
Julie Chua
ONC Sponsor
julie.chua@hhs.gov
Zachary May
Project Manager, RI/Pilot Lead
zachary.may@esacinc.com
Amanda Nash
Standards/Harmonization Lead
Standards Development Support Team Lead
amanda.j.nash@accenturefederal.com
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