Addressing Meeting 2010-05-12

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Notes from Addressing & Directories Workgroup
Status of Notes: DRAFT
Date: May 12, 2010
Time: 3:30pm-4:30pm
Attendees: Honora Burnett, Arien Malec, Sara Robinson, David Kibbe, Wes Rishel, John Moehrke, Karen Witting, Mark Stine, Chris Lomonico
& Jackie Key

Actions from This Meeting
Due Date
Arien will carry the issue of the Addressing/Directories WG to the NHIN Direct Policy Steering Committee
Arien will take a pass at writing up the charter and post it to the Wiki
WG will review charter

Decisions from this Meeting

David Kibbe will be WG lead
Charter will include charge to make policy topics for consideration recommendations to the HITPC

Agenda and Framing
· Who is an approved provider, and would like to look it up that way
· Belief that provider director could help enforce privacy & security
· IHE has been hard at work with a provider specification – going through committee approval and will be out for public comment this week or next
· Karen/John give an update
· Reformatting the charter and defining the goals/objectives
· Heat about the work IHE has done
· Wes will be doing policy work – look for a different WG lead
· Formatting rules have not been specified
IHE Provider Directory Specification
· LDap plus
o Schema to lay on top of LDAP
· IOS standard
· Supporting relationships between providers
o Providers are any of the following:
§ Individual person
§ Organization
§ Relationship isn’t hierarchical
§ Directed Acyclic Graph
· Brings in web services interfaces across organizational boundaries
· Intended for a global audience – US might have to add in regional specific things
· Won’t be released publically for a few weeks
Defining Goals/Objectives of the Group
Comment from Arien
1) Policy considerations about addressing/directories – stay out of that space but highlight things to think about
2) Think about standards – including IHE approach
3) Look at how given the existence of directories how the core things we’ve defined would use directories
Comment from Sara Robinson
· Not increasing scope of concrete implementation group
Comment from David Kibbe
· Any dependencies on directories service and backbone protocol/architecture for HISP->HISP NHIN Direct
· Where do the directories reside?
o In scope: externally facing directories and have a valuable address that is routable
Comment from Wes Rishel
· Not an advocate of that camp
· Scalability of the out of band approach
· Scenario for sending data to a physician in WI
· Keeping a directory up to date, and how would we know we’re really dealing with an organization that is keeping it up to date
· Technically feasible approach without a lot of time worrying about policy feasibility
· Supplementary or dependent relationship
· Data is only good when providers care about it
· Not our job to do policy
· Supplementary vs. dependent
Comment from John Moehrke
· Agreeing with the current flow
o Not a mandatory requirement for NHIN Direct to resolve
o Not a good idea to identify endpoints because they won’t go through the out of band expertise of making sure the receiver is ready to receive or wants to receive
o Scope of NHIN Direct – pick up the phone and all the clinic
o Other hand – are there good schemas for this? Then that isn’t bad work for us to accomplish
o Falls into a lower priority
Comment from Chris Lomonico
· Kantara should allow us to define that they are true endpoints
· Communication rules – good thing to have
Comment from Mark Stine
· How will these affect some of the core things we’re doing?
· Areas we want to make adjustments or add additional user stories to encompass provider directories
· Abstract model adjusted slightly?
Arien is going to reframe the issue
· Is there a compelling reason to take this work on?
· Don’t dispute the utility of this
· Votes for optional, shouldn’t be required, could be solved out of band
· Sarah Robinson: Shouldn’t take this on
Comment from David Kibbe
· Difficult to sell NHIN Direct if there isn’t a trusted entity that is in charge of this
· Recognize that this is an important issue
· Is there any value to having this be across the HISPs?
o Benefit to normalize those directory services? Is this the work that IHE has done?
· Value in saying that if this is chosen, then there is one way of doing it
Comment from Wes Rishel
· Multiple things called directories
o One is a facility that a HISP uses to understand how to reach another HISP
o End point – could determine the complete address of another endpoint to initiate a transition
· Want to avoid specifying how things work internally
· Need is compelling at the level of showing it as part of the vision and showing that the technology won’t be an obstacle
· Argue that having some activity on this is important
· Argue that the activity has to be in the same timeframe (doesn’t have to be in the same timeframe as the other deliverables)
· Charter:
o Show that integration of directory services with NHIN Direct addressing is feasible
o Desirable to recommend a technically feasible, standard way of doing it
Comment from John Moehrke, Karen Whiting, Mark Stine
· Don’t see that we need this right away
· Recognizing this work, but deferring it
Comment from Wes Rishel
· Ensure there is a user story that demonstrates the business value of this
· Facilitate a way for group members to comment on IHE when it is in public comment period
· We go give participants in NHIN Direct to come to consensus about an NHIN Direct comment
Comment from David Kibbe
· Most important workgroup
· Don’t want to miss the opportunity to win the endorsement & trust of the medical professional societies – not asking them to participate
· Don’t need to spend a lot of time on this
· We could put up a straw man proposal for a national directory and solicit the input from medical directory specialties
Comment from Arien Malec
· Technology proof statement
· Comments to IHE Work
· Recommendations of if you did it then here is how we could

· Policy issues and how that would work with medical societies
o Good thing
o NHIN WG or HITPC activity

· Two things that seem to add value
o 1) Comment back to IHE on the directory specification
o 2) Technology proof of concept for how to include directory look ups and NHIN Addressing
§ Simple as saying – in an IHE LDAP directory, here is where you put the address

· Wes & David will engage on the NHIN WG

· Stay out of (critically important, but not our problem)
o Medical societies commenting on IHE proposals
o Policy considerations for national provider directories and the role of the medical societies in that
§ HIT Policy Committee having a testimony would work
§ Challenge is that who is going to be handling the directory?
§ We need a resolution of this issue

· We could submit a request for provider directories to NHIN Exchange
· We need to give a level of support to our sponsors in ONC that we are not ignoring this problem, and that we will look at the technology issues
· Question about is the data up to date and where did it come from
o Recognize that they are important issues
o Hope that the policy committees will address that issue
· Arien will carry the issue of the Addressing/Directories WG to the NHIN Direct Policy Steering Committee
· Arien will take a pass at writing up the charter and post it
· WG will review charter

· David Kibbe will be WG lead
· Charter will include charge to make policy topics for consideration recommendations to the HITPC