Implementation Group Meeting 2010-08-10

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Notes from the NHIN Direct Implementation Group

Date: August 10, 2010
Time: 3pm - 4:30pm
Akira Technologies, Inc, Amedisys, Atlas Development, CareSpark/Anakam HIE Tech, Cerner, Clinical Groupware Collaborative, CSC, eClinicalWorks, Emdeon, Epic, Google, Greenway Medical Technologies, High Pine Associates , IBM, Inpriva, Kaiser, Kryptiq, Massachusetts eHealth Collaborative, MedAllies, Medical University of SC, South Carolina Research Authority, Medicity, MedPlus/Quest Diagnostics, Microsoft, Misys Open Source Solutions (MOSS) , Oregon HIE Planning Team, Redwood MedNet, RelayHealth, Rhode Island Quality Institute, Siemens, SureScripts, Techsant Technologies, VisionShare


»Achieving the NHIN Direct Vision
»NHIN Direct August Face to Face Meeting Details
»Workgroup Updates
»Calendar & Participation


Uvinie Hettiaratchy
· Pointed out changes to the timeline slide: now the “October” events are projected for November
· àWiki organizations page: please correct and update (if an organization is not on the list, they will be removed)
· àLet Uvinie know if you want to be brought in as observers be emailing her ASAP
· àTO EDIT: you must join the wiki (if you don’t see a little Edit box on the corner of the page, it means you are not a member (1) click “become a member”(2) follow the steps to create a user profile and to join the wiki)
· Reviewed NHIN Direct vision statement: “every provider and every patient in the country can securely send and receive clinical information”
· August Face-to-Face Meeting (August 17 – 18, 2010)
o Only one representative per organization, though there is still room for folks with technical skills who can contribute to code-a-thon, documentation-a-thon or plan-a-thon
o Agenda still under revision, will be up on wiki later in the week
o First four hours: Code-a-thon, Documentation-a-thon, Plan-a-thon
o Starting in Department of Health and Human Services in the Humphrey building at 9am but please arrive 8:30am for security purposes
o More details:
When: August 17th(9 am-4 pm EST) & August 18th(9 am-11:30 am EST)
Where: Department of Health and Human Services, Hubert H. Humphrey Building, Room 705A (200 Independence Avenue S.W. Washington, D.C. 20201)
•Dial in Information: 1-866-816-4209 Participant Code: 3980879
Why: To close key NHIN Direct deliverables (a detailed agenda will be posted to the wiki later this week)
Who: One representative of each NHIN Direct Member Organization and all WG leads.
How to attend: The name of the representative should be up on the wiki: [1]
Please let us know ASAP if the information is incorrect.

Workgroup Updates:

Implementation Geographies (Lead: Paul Tuten)
· Purpose of the workgroup: strong weekly oversight of pilot projects, help ensure desired outcomes and demonstrate measurable value

  • Currently 7 pilot programs

Pilots projects: Rhode Island Quality Institute, Medical Professional Services, MedAllies, CareSpark, Carolina eHealth Alliance, Redwood MedNet, VisionShare
· àUsers can look at links on WG page to determine WG needs and other ways to contribute
Resource and Collaboration Needs for Pilot Projects page: [2]
Information Technology Provider matrix: [3]
· àIf interested in setting up a pilot project and want to see guidelines, go to

Security & Trust WG (Lead: Sean Nolan)
· Purpose is to provide alternatives and highlight issues relating to security and trust enablement via technology (e.g., certificates and signatures)
· Key August 17thDeliverable: Security & Trust Threat Assessment Model
· Did not meet last week
· The WG is working on :
o Threat Model Process
o Threat Model -SMTP with Full Service HISPs
o Threat Model -Simple SMTP
· The WG set action items to:
o Continue work on Security & Trust Threat Assessment Model
o Create table with encryption options, noting PHI exposure risks
o Overall, trying to provide more guidance for implementation teams about what threats they might face and how to comply

Reference Implementation WG (Lead: Brian Behlendorf)
§ Purpose is to create a solid open-source reference implementation and associated libraries implementing the NHIN Direct specifications.
§ Key August 17thDeliverable: Draft Reference Implementation
§ WG updates:
o Good progress on CSharp Implementation under the leadership of Microsoft
o Good momentum and key leaders established for Java Implementation
o Will have a Code-a-Thon during the Face to Face meeting.
§ àCall for developers to participate in the Face to Face
o Goal: pulling together people in person to complete those tasks which take too long to complete virtually: objectives to lay out tasks, make key architectural decisions, and set off on planning week-long virtual sprint planned for after the Face to Face

Documentation and Testing WG (Lead: Janet Campbell)
· Purpose is to create effective documentation and testing guidance for implementers including: specification documentation, implementation guides, and conformance testing guides
· Key August 17thDeliverable: (Document-a-thon in the a.m.)
o Prioritized document artifact list
o Final draft of Rank 1 documents
§ Certification Checklist (Client Side and HISP), Overview of NHIN Direct, Overview of NHIN Direct Security, S/MIME Sec Agent Specification
o Preliminary draft of Rank 2 documents
§ SMTP, S/MIME, CERT guide, XDD Specs, XDD Dev Guide, Policy Questions, Testing Guides
· Abstracts of everything else
· àDo you have a documentation need? Let us know!

Communications WG (Lead: Rich Elmore) (presented by Uvinie)
· Purpose of the work group: The goal of the Communication workgroup is to provide clarity about what NHIN Direct is and how it fits into the health information and transformation ecosystem. Key audiences include State HIEs, RECs, HIOs, health systems, providers, and the larger general health community and media. Foundational work on the NHIN Direct Overview has been
· Key Deliverables:
Materials tailored for communication to each audience (press release, presentations, multi-media)
Outreach / communication plan
Plan execution

  • Meets on Tuesdays (1:00-2:00 PM) rather than Wednesdays
  • Discussed the primary stakeholder groups
  • Members of the WG have agreed upon dividing work to:

Determine the key stakeholders of NHIN Direct
Key questions that need to be addressed

  • Would like a member from a mid-large health group to be represented in the communications WG
  • Will be meeting as well during the document-a-thon

· Call for participants –If you would like to be part of this workgroup, please email Uvinie Hettiaratchy (


  • Activities for early morning aside the code-a-thon?

Brian Behlendorf – Three miniature sprints

      1. Coding
      2. Documents
      3. Planning
        1. How do we get from here until the testing the pilots?
          1. This Planning is focused on getting from here to successful pilot. If you don’t feel you fit into coding or documenting, planning might be the best place. This will be a strategic high-level discussion.

Kim Long – Does the current timeline address Priority 2 or 3 user stories?

    • Its open to be an agenda item for next week
    • Kim will reach out to Arien for clarification, and report back to the group