Updates on the Western States Consortium
Transcript of Updates on the Western States Consortium
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Robert M. Cothren, PhDCalifornia Health eQuality Program
IPHI / UC Davis Health System
Update on the Western States Consortium
January 28, 20133:00PM
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Office of the National Coordinator for Health Information Technology
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Who is the WSC?
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What are we doing?
Office of the National Coordinator for Health Information Technology 3
Investigating the policies, procedures, and technologies that allow and promote interstate exchange of health information.
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What is the issue?
Use case…Using Direct to exchange clinical information between providers across state lines for treatment purposes.
A simple use case that allows us to concentrate on
interstate exchange.
Office of the National Coordinator for Health Information Technology 4
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Who is participating… as proposed?
• One data sharing agreement• One exchange of digital certificates• One exchange of user addresses
Focus on the issues of interstate exchange.
Office of the National Coordinator for Health Information Technology 5
OregonCalifornia
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Who will be participating… soon?
• Six data sharing agreements• Six exchanges of digital certificates• Six (ongoing) exchanges of user addresses
Focus on the issues of scalable trust.
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Oregon
California
Alaska
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Again… What is the issue?
Office of the National Coordinator for Health Information Technology 7
Use case…Using Direct to exchange clinical information between providers across state lines for treatment purposes.
Really about scalable trust.
Two important components…1. Establishing inter-organizational trust.2. Discovering how to communicate with others.
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Office of the National Coordinator for Health Information Technology
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How is trusted exchange established?
The Western States Consortium Trust Community
Developed “umbrella governance organization”: signatories to an MOU establishing the Governance Body.– Currently includes
California, Oregon,and Alaska.–Other core states
evaluating whenthey can join.
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Office of the National Coordinator for Health Information Technology
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How is trusted exchange established?
The Western States Consortium Trust Community
Developed “umbrella governance organization”: signatories to an MOU establishing the Governance Body.
Developed a set of Eligibility Criteria for Qualified Entities joining the WSC Trust Community.– Based on…
…Direct Applicability Statement, and technical standards
…ONC guidance on directed exchange. policies and procedures
– Memorialized in policies and procedures.
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Office of the National Coordinator for Health Information Technology
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How is trusted exchange established?
The Western States Consortium Trust Community
Developed “umbrella governance organization”: signatories to an MOU establishing the Governance Body.
Developed a set of Eligibility Criteria for Qualified Entities joining the WSC Trust Community.
Developed procedures for collecting, managing, and distributing a Trust Bundle that identifies Qualified Entities.–Manual process now.–Move to a standardized process under development.
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Office of the National Coordinator for Health Information Technology
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How is trusted exchange established?
The Western States Consortium Trust Community
Developed “umbrella governance organization”: signatories to an MOU establishing the Governance Body.
Developed a set of Eligibility Criteria for Qualified Entities joining the WSC Trust Community.
Developed procedures for collecting, managing, and distributing a Trust Bundle that identifies Qualified Entities.
Testing in a pilot.– Adding states to the Governance Body.– Adding Qualified Entities to the Trust Community.–Updating Trust Bundle distribution procedures.
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What is this “Trust Bundle”?
• Collection of public digital certificates or “trust anchors”.– Establishes the electronic identity
of members of the Trust Community.–Managed and published by the
Governance Body.–Memorialized in policies,
procedures, and technology.
Add New Qualified Entity to Trust Community
Party StateGovernance Body Trust Bundle Coordinator
New Qualified Entity POC
Existing Qualified Entity POCs
Requests that Qualified Entity be
added to Trust Community.
Requests Trust Anchor.
Returns Trust Anchor (via email).
Inspects Trust Anchor to verify it
meets Eligibility Criteria.
Places Trust Anchor in test HISP.
Sends trust anchor for test HISP (via
email).
Places trust anchor for test HISP in HISP.
Conducts test of Trust Anchor
Conducts test of Trust Anchor.
Adds Trust Anchor to Trust Bundle.
Sends notice that Trust Bundle has been updated.
Corrects issues.
Notes update to Trust Bundle.
Retrieves Trust Bundle (via FTP) and
places in HISP.
Retrieves Trust Bundle (via FTP) and
places in HISP.
Corrects issues.
Sends notice of addition to Trust
Community.
Notes successful addition to Trust
Community.
Issues? yes
no
Issues?
no
yes
From “Eval of Qualified
Entity”
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What about standards?
• The WSC Trust Bundle is a low-tech solution examining policies and procedures for managing trust anchors.–Distribution: SFTP– Content: trust anchors in an SFTP directory– Change management: out-of-band email alerts
• The developing standard…–Distribution: HTTP or HTTPS– Content: (optionally) signed PKCS7 container
See the Direct Project Trust Bundle Sub Work Group at http://wiki.directproject.org/Trust+Bundle+Sub+Work+Group.
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Once more… What is the issue?
Office of the National Coordinator for Health Information Technology 14
Use case…Using Direct to exchange clinical information between providers across state lines for treatment purposes.
Really about scalable trust.
Two important components…1. Establishing inter-organizational trust.2. Discovering how to communicate with others.
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How are addresses discovered?
Directory Services
Developed architecture for distributed management of individual (and organizational) addresses.– States query each other.– The architecture within each state
is up to the state.– California is also federating directories.
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How are addresses discovered?
Directory Services
Developed architecture for distributed management of individual (and organizational) addresses.
Developing functional requirements and expected behavior for state-level directories.– To be memorialized in policies and procedures.–May include eligibility criteria for participating in Directory
Services.
Office of the National Coordinator for Health Information Technology 16
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How are addresses discovered?
Directory Services
Developed architecture for distributed management of individual (and organizational) addresses.
Developing functional requirements and expected behavior for state-level directories.
Developing standardized query for state-level directories.– Based on previous work.– In California, also being used for internal federation.
Please let us know if you would like to participate!
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How are addresses discovered?
Directory Services
Developed architecture for distributed management of individual (and organizational) addresses.
Developing functional requirements and expected behavior for state-level directories.
Developing standardized query for state-level directories. Testing in a pilot.– Adding states to the architecture.– Adding local directories in California.– Learning how it all might work.
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What about standards?
• Based on the work of other “standards” organizations.– IHE Healthcare Provider Directory (HPD)– S&I Framework guidance for queries– EHR|HIE Interoperability Workgroup (HPDPlus)
• Developing standards…–HTTP and TLS– SOAP web services–HPD / HPDPlus data model–DSML query and response
See the December HITRC PD CoP meeting for more…http://hitrc-collaborative.org/confluence/download/attachments/12419271/Provider+Directory+CoP+Membership+Mtg+2012+12+19+FINAL.pptx
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Office of the National Coordinator for Health Information Technology
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When can I see it?
Overlapping Trust Communities
WSC Trust Community
CA Trust Community
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Office of the National Coordinator for Health Information Technology
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When can I see it?
Distributed Directory Services
OR State Directory ServiceCA State Directory Service
RWMN Local Directory Service NCHIN Local Directory Service
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Questions?