Gretchen Wyatt ONC Dr Lauren Thompson Director FHA Agenda Federal Health IT Priorities Impact of Federal Health IT Priorities on FHAs Strategic Plan 2 Gretchen Wyatt Office of the National Coordinator for Health ID: 731713
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Impact of Federal Health IT Priorities on FHA Strategic Plan
Gretchen Wyatt, ONC
Dr. Lauren Thompson, Director, FHASlide2
Agenda
Federal Health IT Priorities
Impact of Federal Health IT Priorities on FHA’s Strategic Plan
2Slide3
Gretchen Wyatt
Office of the National Coordinator for Health
IT
FEDERAL HEALTH IT PRIORITIES
3Slide4
FHA Strategic Plan –
Vision
A Federal health information technology environment that is interoperable with the private sector and supports the President’s health information technology plan enabling better care, increased efficiency, and improved population health
4Slide5
Federal Health Architecture:
Advancing National Health IT
FHA Moving Forward: 2014
STRATEGIC GOALS
Establish a unified federal voice on health data
exchange and interoperability
Establish FHA as a “convener of stature”, and broaden participation
Institutionalize governance decision-making processes
Expand outreach and access to tools
Achieve adoption of interoperability specifications, leading to active data exchange in the Federal health community
Support S&I Framework by providing federal use cases
and pilots
Enable FHA partners to move from legacy to new solutions in effective, coordinated manner
Align federal policies in healthcare data exchange
Provide a forum of cataloging and aligning federal policies and practices
FHA Guiding PrinciplesStakeholderEngagementDemonstratethrough PilotsOpen Communicationand TransparencyCommitmentto ActionFocus onSpecifications
5Slide6
Impact of Federal Health IT Priorities
FHA Strategic Plan grows and evolves to support federal health IT priorities
FHA federal partners contribute to development of priorities, ensure addition of federal requirements
FHA encourages federal agencies to adopt priorities to their unique health IT requirements
6Slide7
Current FHA Health IT Priorities
Healthcare Directory
Patient Consent & Authorization
Directed ExchangeCONNECT
Federal Health Information Model (FHIM)Integrating with the Standards and Interoperability Framework
Patient Identification
This is an ONC priority that FHA supports.
7Slide8
CONNECT Open Source Community Development
CONNECT is moving to the open source community for management
FHA will remain engaged to ensure developments include federal requirements
Join the CONNECT Open Community Collaboration today: http://www.connectopensource.org/developer-resources/forums
8Slide9
Engagement in the Standards & Interoperability (S&I) Framework
Support for Federal partner priorities such as Meaningful
Use
Direct support of Federal partner use
cases
FHIM provides semantic and syntactic modeling constructs to support the definition of
information
FHIM, combined with MDHT
*
,
can be used to generate implementation standards using
an MDA
*
approach
*MDHT - Model Driven Health Tools*MDA - Model Driven Architecture
9FHIMS&I
Requirements
Scope
Modeling
Data Collection
Publish
Discovery
Pre-Discovery
Pilot
Impleme
ntation
EvaluationSlide10
FHA Workgroups
Core workgroups that support federal health IT priorities:
Architecture & Modeling
Data Exchange & InteroperabilityCommunications & Coordination
Directed Exchange
10Slide11
Stay connected, communicate and collaborate
Find out more about FHA on the ONC website:
http://www.healthit.gov/
FHA Contact us at: federal.health@hhs.gov
Subscribe, watch, and share: @
ONC_FHA,
@
CONNECT_Project
http
://www.flickr.com/photos/federalhealtharchitecture
/
11Slide12
Applying RESTful Health
Exchange, FHIR,
and
Direct
ONC Annual Meeting
Ollie Gray (TATRC)
24 January 2014Slide13
Outline
RESTful Health Exchange
RESTful Health Exchange Addresses Gaps
Research, Development, Testing and Evaluation (RDT&E) with REST and DirectRDT&E OutcomesSummarySlide14
14
RESTful Health Exchange
Open source project to apply Web technologies to demonstrate a simple, secure, standards-based health information exchange
Builds the foundation for patient access to data via the Web and mobile devices,
facilitating
broad
electronic health data exchange
Offers a new approach to health data
exchange:
Replaces
moving
documents
to linking to needed informationSponsored by the Federal Health Architecture (FHA) program in FY12, TATRC in FY13 and FY14, VHA in FY14Addresses NwHIN Power Team recommendation to develop a specification for RESTful exchange of health dataApplies RESTful health data exchange to key capability gapsVHA=Veterans Health AdministrationNwHIN=Nationwide Health Information Networkhttp://wiki.siframework.org/RHExREST
technology enables secure, Web-based health data exchangeSlide15
RESTful Health Exchange Addresses Gaps
SMTP (Direct) does not scale to allow sharing of very large files, such as diagnostic images
Lightweight exchange is needed to allow health information sharing with out-of-network providers
Standing up CONNECT can be a challenge for small, independent providers and providers in rural areas
CONNECT capabilities not needed for stateless transactions
15Slide16
Research, Development, Testing and Evaluation (RDT&E) with REST and Direct
Improved Coordination of Care ~ Timely Remote Record Access ~ Low barrier of entry
16Slide17
REST with Direct
for
Sharing Diagnostic Images
Demonstrated in a RDT&E environment that MHS
and third
-party providers can access diagnostic images
and
associated records
securely
over the
Web
MHS = Military Health System
PCM = Primary Care
Manager
Improved Coordination of Care ~ Timely Remote Record Access17Slide18
RDT&E Outcomes
RDT&E initiatives successfully demonstrated that:
Physicians can securely share health data over the Web
Diagnostic images can be shared using REST with DirectHigh volumes of data can be moved over the Web securely in support of HIE patient data integrationRESTful capability is being implemented across Maine to support small, independent providers and FQHCs in medically underserved areas
New Pilot with TATRC in FY14
REST and FHIR technology being explored as possible solutions for government HIE exchanges
New pilot with VHA Office of Rural Health (ORH)
REST, FHIR, and Direct technology
will support s
ecure sharing of information between VHA and third-party providers in support of
home healthcare for Veterans
in rural
Utah
FQHC
= Federally Qualified Health CenteriEHR = integrated Electronic Health Record18Slide19
Summary
RDT&E initiatives with REST and Direct have
addressed gaps in
capabilityOut-of-network providers can share information securely over the Web using REST
Direct + REST can be used to share diagnostic images in a scalable fashionREST can be used to allow small, independent providers and providers in rural
areas to exchange health information
RDT&E
initiatives contributed to the goals of:
Improved
care
coordination
Equal healthcare for all
Timely remote record access
Low barrier-of-entry
for small practicesApplicability of FHIR is being exploredGoals map to :http://www.himss.org/ValueSuite19Slide20
24 January 2014
Deb Gallagher, GSA
FPKIPA Chair
ONC Annual MeetingFederal Priorities for Health IT Training Session
Federal PKICross-Certifictation
OverviewSlide21
Work Groups and Tiger Teams
FPKI Overview
FPKI
Cross-Certification ProcessCross-Certified AffiliatesPIV-I ProvidersEGCA Overview
and Purpose21
AgendaSlide22
Criticality of PKI
PKI
p
rovides identity authentication, integrity, confidentialityFormal controls for certificate issuance and management enable trust in these services
22
Consumer Online
Shopping and Banking
CAC Card Access to
Systems and Facilities
Trusted B2B, G2B, C2B, C2G Communications
PIV Card Access to
Systems and Facilities
Trusted Network
Devices and VPN
Signed Code for Trusted Execution
Public Key Infrastructure
Government Trusted by Commercial Organizations
Commercial Organizations Trusted by Government
Policies and Governance
Trusted Issuers
Trusted Algorithms
Revocation and Validation
PKI Enables
PKI Trust
ComponentsSlide23
FPKI Purpose
The FPKI facilitates federated identity
Throughout the Federal Government; and
Between the Federal Government and external partnersIncludes the FPKI Trust InfrastructureFederal Bridge Certificate Authority (FBCA) Cross-certification assures comparability of certificate issuance policiesIncorporates multiple assurance levelsFederal Common
Policy CA (FCPCA) Trust Anchor for the U.S. Federal GovernmentE-Governance CAs (EGCA)
Supports various ICAM Programs
The
FPKI Policy Authority (FPKIPA)
governs policies for
operation of the FBCA,
FCPCA, and EGCA
Operates
under the authority of the Federal CIO
Council
23Slide24
Cross-Certification Process Overview
24Slide25
Currently Cross-Certified Affiliates
Federal Agencies
Department of Defense (DoD);
Department of State (DoS); Drug Enforcement Administration (DEA CSOS);
Government Printing Office (GPO); Department of Treasury; United States Postal Service (USPS); and
United States Patent and Trademark Office (USPTO)
Two PKI Bridges
CertiPath
:* Aerospace and Defense
Eid
Passport*
Cassidian
*
Carillion*
Non-Federal PKIsState of IllinoisEntrust*Verizon Business*Symantec*ACES – ORC & IdentrustDoD ECAsDigiCert*ORC*IdentrustExostarSAFE-BioPharma: Pharmaceutical and healthcare industries= PIV-I Provider25Slide26
EGCA – Supports ICAM
The EGCA supports the ICAM mission by:
Enabling governance
– control which endpoints participate and can be trusted for technical interoperability or information sharing.Conveying trust between endpoints in a transaction – allow endpoints to determine trust at run time.Facilitating secure communications between endpoints in a transaction – once endpoints have established trust, the ensuing communication between endpoints is secure.
The EGCA supports ICAM Assertion-based Initiatives
Issues certificates to devices and applications.
Issues different types of certificates to different types of endpoints.
Enables trusted access to government services for more participants and communities of interest (e.g., commercial and financial communities).
26Slide27
Questions?
Deb Gallagher
General Services Administration
Office of Governmentwide PolicyDirector, Identity Assurance and Trusted Access Division
202.219.1627 (desk)202.604.5733 (mobile)Deborah.Gallagher@gsa.gov
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Q&A ???