Rwmn pilot project brief 20110215

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draft version 0.7 - Last Update: February 15, 2011
Direct Demo at Redwood MedNet HIE Conference : : Photo of Demo at HIE Conference : :
RWMN Pilot Shared Documents : :
User Story x Pilots Crosswalk : : Meaningful Use x Pilots Crosswalk : : Implementation Interoperability Matrix
HIMSS FHA Direct Demonstration : : Cal eConnect ToC Demonstration : : Cal eConnect IZ Demonstration

Will Ross, Project Manager, Redwood MedNet


  1. To field test the DIRECT transport protocol in the Redwood MedNet ("RWMN") health data service cloud
  2. To harmonize the DIRECT content transport capabilities with the clinical practice workflow of small, under-resourced health care delivery sites
  3. To test up to four health data transport patterns
    • Sending Provider inside RWMN-HISP pushes DIRECT message to Receiving Provider inside RWMN-HISP (1 HISP)
    • Sending Provider inside RWMN-HISP pushes DIRECT message to Receiving Provider outside RWMN-HISP (2 or more HISPs)
    • Sending Provider inside RWMN-HISP pushes DIRECT message to Receiving PHR using Microsoft HealthVault (1 or more HISPs)
    • Sending Provider outside RWMN-HISP pushes DIRECT message to Receiving Provider using RWMN-HISP (2 or more HISPs)
  4. To seek the "Aha!" moment that allows a health care provider to choose DIRECT over the fax machine as a preferred health message routing option


Pilot Scope

  • Focus on usability for small provider offices and small unaffiliated hospitals (e.g., critical access, rural, etc.)
  • Limit to use cases with direct consent for patient treatment (no indirect consent or secondary data uses)
  • Seek to populate the 4 x 4 testing matrix (below) with each type of participant (if available)
  • Aim for explicit production use of the Direct transport protocol to meet meaningful use measures for eligible providers
  • Collaborate with State HIE governance entity (Cal eConnect)
  • Collaborate with REC (CalHIPSO) and LECs (HSAG, etc.)
  • Collaborate with CalPSAB to identify consent and privacy solutions

Meaningful Use Measures

  1. Push discharge summary from hospital to primary care provider
  2. Push structured laboratory test results into primary care provider EHR
  3. Push unstructured radiology narrative report into primary care provider EHR
  4. Push IZ messages to regional registry


Version 3 of Redwood MedNet directed messaging pilot.


  • Redwood MedNet HISP
  • RxNT
  • Mirth Corporation
  • e-MDs Corp.
  • Microsoft HealthVault (see materials in Documentation Library)
  • CAIR (California IZ Registries)
  • local hospitals (to be named)
  • local practices (to be named)
  • extra credit: enable telehealth use case

Resources Anticipated Being Available for Pilot

  • Redwood MedNet operates a full CONNECT gateway and can produce or consume standard IHE content formats
    • In February 2010 the Redwood MedNet CONNECT gateway was used for direct bilateral exchange of patient data (proof of concept demonstration)
    • In March 2010 Redwood MedNet demonstrated CONNECT as part of the FHA booth in the HIMSS Interoperability Showcase
  • In July 2010 Redwood MedNet bench-tested an SMTP gateway with an early prototype of the NHIN-D security agent and the XDM content model; for this operational phase a new SMTP gateway will be integrated with the RWMN Mirth MUx technology stack.
  • RWMN-HISP will operate its own Certificate Authority

Success Metrics

  • Use DIRECT transport protocol to push production electronic health data from a sender to a recipient
  • Establish an appropriate Participation Agreement to enable the DIRECT transport protocols to interoperate seamlessly with the formal consent requirements of RWMN
    • Conform with policy articulation by the Privacy & Security Tiger Team
    • Conform to privacy and security requirements from CalPSAB

Other Notes