# Presentation: 353457

## Personalized Health Care Workgroup 

**Presentation for the **
**Personalized Health Care Workgroup **

**March 17, 2008**

## Health Care Challenges Today

**Increasing numbers of uninsured Americans:  The Census Bureau reports 47 million without health insurance in 2006**
- another 17 million lack coverage for treatments necessary to fight  cancer and other very serious diseases
**At least 1.5 million preventable adverse drug events occur in**
**the United states each year**
- Among the recommendations of a 2006 Institute of Medicine report is that, “... regulatory agencies should encourage the adoption of practices and technologies that will reduce medication errors.” *(Preventing Medication Errors, IOM, July 06)*
**Continuing rise of healthcare costs as % of GDP**
- 16% ($2.1 trillion) in 2005; estimated in 2015, 20% ($4 trillion) *(National Coalition on Healthcare)*
**Growing federal government share of healthcare costs**
- currently, 45%; projected to pay about 50% in the next 10 years *(Washington Post, February 21, 2007)*

**Health Care Challenges Today**

## Executive Order 13335 – April 27, 2004
Announces commitment to the promotion of health IT
President Bush calls for widespread adoption of interoperable EHRs within 10 years
Establishes the Office of the National Coordinator (ONC)	

Executive Order 13410 – April 22, 2006
Requires federal agencies to perform the following:
As each agency implements, acquires, or upgrades health information technology systems used for the direct exchange of health information between agencies and with non-Federal entities, it shall utilize, where available, health information technology systems and products that meet recognized interoperability standards. 

**Executive Order 13335 – April 27, 2004**
**Announces commitment to the promotion of health IT**
**President Bush calls for widespread adoption of interoperable EHRs within 10 years**
**Establishes the Office of the National Coordinator (ONC)**
**Executive Order 13410 – April 22, 2006**
**Requires federal agencies to perform the following:**
- As each agency implements, acquires, or upgrades health information technology systems used for the direct exchange of health information between agencies and with non-Federal entities, it shall utilize, where available, health information technology systems and products that meet recognized interoperability standards.

**Presidential Executive Orders**

## Today’s Health IT Environment:What are the Federal Agencies doing?

**Implement HITSP harmonized standards**
**	****Adopt use of CCHIT Certified Products**
**	**
**	**
**	****Employ NHIN Compliant Services to ****	****exchange health information**

## Today’s Health IT Environment:What steps are required for Agencies to implement solutions

**Today’s Health IT Environment:****What steps are required for Agencies to implement solutions**

- How does an agency implements acquire, or upgrade health information technology systems used for the direct exchange of health information?

##  FHA Program Tools and Services

**Federal Implementation Tools and Services**

**** Available for use by****** ******state, tribal, local governments & others***

- NHIN-Connect (C) Gateway*
- NHIN-C Software Development Kit for agency connectivity to NHIN-C*
- NHIN-C Community Portal*

- HITSP Engagement Plan
- SDO Engagement Plan
- Standards Catalogue
- Terminology Distribution Specification

- Health Information Interoperability Architecture Framework (HIIAF)*
- Federal Transition Framework (FTF)
- AHIC Use Cases Business Process Models (BPM)*

- Instructor-led Training Courses
- Computer Based Training Courses
- Interoperability Specifications
- Health info exchange
- Architecture
- Investment planning
- Implementation

**HIT Education**

**Investment Planning ****and Progress Reporting**

**Interoperability****Architecture**

**Standards Adoption**

**Health Information****Exchanges**

- Investment Planning & Reporting Guide*
- Health Information (HI) Survey
- Implementation Planning Guide
- Standards Compliance Methodology

- Agency Health Information Exchanges Requirements Definition
- NHIN Implementation  Support

- Agency Participation Planning Support
- 	- HITSP
- 	- SDO
- 	- Terminology Distribution

- Agency Transition Planning Support

- Webinars
- Briefings
- On-site Presentations

- Agency Investment Planning Support
- ImplementationPlanning Support

**TOOLS**

**SERVICES**

##  FHA Program Tools and Services

**Federal Implementation Tools and Services**

**** Available for use by****** ******state, tribal, local governments & others***

- NHIN-Connect (C) Gateway*
- NHIN-C Software Development Kit for agency connectivity to NHIN-C*
- NHIN-C Community Portal*

- HITSP Engagement Plan
- SDO Engagement Plan
- Standards Catalogue
- Terminology Distribution Specification

- Health Information Interoperability Architecture Framework (HIIAF)*
- Federal Transition Framework (FTF)
- AHIC Use Cases Business Process Models (BPM)*

- Instructor-led Training Courses
- Computer Based Training Courses
- Interoperability Specifications
- Health info exchange
- Architecture
- Investment planning
- Implementation

**HIT Education**

**Investment Planning ****and Progress Reporting**

**Interoperability****Architecture**

**Standards Adoption**

**Health Information****Exchanges**

- Investment Planning & Reporting Guide*
- Health Information (HI) Survey
- Implementation Planning Guide
- Standards Compliance Methodology

- Agency Health Information Exchanges Requirements Definition
- NHIN Implementation  Support

- Agency Participation Planning Support
- 	- HITSP
- 	- SDO
- 	- Terminology Distribution

- Agency Transition Planning Support

- Webinars
- Briefings
- On-site Presentations

- Agency Investment Planning Support
- ImplementationPlanning Support

**TOOLS**

**SERVICES**

##  FHA Program Tools and Services

**Federal Implementation Tools and Services**

**** Available for use by****** ******state, tribal, local governments & others***

- NHIN-Connect (C) Gateway*
- NHIN-C Software Development Kit for agency connectivity to NHIN-C*
- NHIN-C Community Portal*

- HITSP Engagement Plan
- SDO Engagement Plan
- Standards Catalogue
- Terminology Distribution Specification

- Health Information Interoperability Architecture Framework (HIIAF)*
- Federal Transition Framework (FTF)
- AHIC Use Cases Business Process Models (BPM)*

- Instructor-led Training Courses
- Computer Based Training Courses
- Interoperability Specifications
- Health info exchange
- Architecture
- Investment planning
- Implementation

**HIT Education**

**Investment Planning ****and Progress Reporting**

**Interoperability****Architecture**

**Standards Adoption**

**Health Information****Exchanges**

- Investment Planning & Reporting Guide*
- Health Information (HI) Survey
- Implementation Planning Guide
- Standards Compliance Methodology

- Agency Health Information Exchanges Requirements Definition
- NHIN Implementation  Support

- Agency Participation Planning Support
- 	- HITSP
- 	- SDO
- 	- Terminology Distribution

- Agency Transition Planning Support

- Webinars
- Briefings
- On-site Presentations

- Agency Investment Planning Support
- ImplementationPlanning Support

**TOOLS**

**SERVICES**

##  FHA Program Tools and Services

**Federal Implementation Tools and Services**

**** Available for use by****** ******state, tribal, local governments & others***

- NHIN-Connect (C) Gateway*
- NHIN-C Software Development Kit for agency connectivity to NHIN-C*
- NHIN-C Community Portal*

- HITSP Engagement Plan
- SDO Engagement Plan
- Standards Catalogue
- Terminology Distribution Specification

- Health Information Interoperability Architecture Framework (HIIAF)*
- Federal Transition Framework (FTF)
- AHIC Use Cases Business Process Models (BPM)*

- Instructor-led Training Courses
- Computer Based Training Courses
- Interoperability Specifications
- Health info exchange
- Architecture
- Investment planning
- Implementation

**HIT Education**

**Investment Planning ****and Progress Reporting**

**Interoperability****Architecture**

**Standards Adoption**

**Health Information****Exchanges**

- Investment Planning & Reporting Guide*
- Health Information (HI) Survey
- Implementation Planning Guide
- Standards Compliance Methodology

- Agency Health Information Exchanges Requirements Definition
- NHIN Implementation  Support

- Agency Participation Planning Support
- 	- HITSP
- 	- SDO
- 	- Terminology Distribution

- Agency Transition Planning Support

- Webinars
- Briefings
- On-site Presentations

- Agency Investment Planning Support
- ImplementationPlanning Support

**TOOLS**

**SERVICES**

##  FHA Program Tools and Services

**Federal Implementation Tools and Services**

**** Available for use by****** ******state, tribal, local governments & others***

- NHIN-Connect (C) Gateway*
- NHIN-C Software Development Kit for agency connectivity to NHIN-C*
- NHIN-C Community Portal*

- HITSP Engagement Plan
- SDO Engagement Plan
- Standards Catalogue
- Terminology Distribution Specification

- Health Information Interoperability Architecture Framework (HIIAF)*
- Federal Transition Framework (FTF)
- AHIC Use Cases Business Process Models (BPM)*

- Instructor-led Training Courses
- Computer Based Training Courses
- Interoperability Specifications
- Health info exchange
- Architecture
- Investment planning
- Implementation

**HIT Education**

**Investment Planning ****and Progress Reporting**

**Interoperability****Architecture**

**Standards Adoption**

**Health Information****Exchanges**

- Investment Planning & Reporting Guide*
- Health Information (HI) Survey
- Implementation Planning Guide
- Standards Compliance Methodology

- Agency Health Information Exchanges Requirements Definition
- NHIN Implementation  Support

- Agency Participation Planning Support
- 	- HITSP
- 	- SDO
- 	- Terminology Distribution

- Agency Transition Planning Support

- Webinars
- Briefings
- On-site Presentations

- Agency Investment Planning Support
- ImplementationPlanning Support

**TOOLS**

**SERVICES**

##  FHA Program Tools and Services

**Federal Implementation Tools and Services**

**** Available for use by****** ******state, tribal, local governments & others***

- NHIN-Connect (C) Gateway*
- NHIN-C Software Development Kit for agency connectivity to NHIN-C*
- NHIN-C Community Portal*

- HITSP Engagement Plan
- SDO Engagement Plan
- Standards Catalogue
- Terminology Distribution Specification

- Health Information Interoperability Architecture Framework (HIIAF)*
- Federal Transition Framework (FTF)
- AHIC Use Cases Business Process Models (BPM)*

- Instructor-led Training Courses
- Computer Based Training Courses
- Interoperability Specifications
- Health info exchange
- Architecture
- Investment planning
- Implementation

**HIT Education**

**Investment Planning ****and Progress Reporting**

**Interoperability****Architecture**

**Standards Adoption**

**Health Information****Exchanges**

- Investment Planning & Reporting Guide*
- Health Information (HI) Survey
- Implementation Planning Guide
- Standards Compliance Methodology

- Agency Health Information Exchanges Requirements Definition
- NHIN Implementation  Support

- Agency Participation Planning Support
- 	- HITSP
- 	- SDO
- 	- Terminology Distribution

- Agency Transition Planning Support

- Webinars
- Briefings
- On-site Presentations

- Agency Investment Planning Support
- ImplementationPlanning Support

**TOOLS**

**SERVICES**

## Nationwide Health Information Network (NHIN)

**FROM THE NATIONAL HIT AGENDA:**

**...****foster widely available services that facilitate the accurate, appropriate, timely, and secure exchange of health information**
**...****information that:**
- 	-  follows the consumer
- 	-  supports clinical decision
- 	-  integrates public health needs

## Upon release of NHIN trial implementations RFP, Feds were energized to determine how to connect to the emerging NHIN
FHA governance chartered the “NHIN-Connect” initiative to define a strategy, plan and requirements for connecting to the emerging NHIN
Six principles guided the development of the strategy

**How the Federal Effort was Started**

**Upon release of NHIN trial implementations RFP, Feds were energized to determine how to connect to the emerging NHIN**
**FHA governance chartered the “NHIN-Connect” initiative to define a strategy, plan and requirements for connecting to the emerging NHIN**
**Six principles guided the development of the strategy**

**Inclusivity**
**Collaboration**

**Proactivity **
**Incrementalism**

**Reuse**
**Continuity**

- November 14, 2007

## NHIN can support agency priorities such as:
Wounded Warrior
Disability and Long Term Care
Continuity of care across federal, tribal and community-based health providers
Pandemic/Disaster 
Situational Awareness
Post-Market Surveillance of drugs and durable medical goods
Bio-surveillance
Submission of evidence for disability and claims processing
Anonymized clinical data to support research
Quality metrics for determining value in health care
Emergency response

**NHIN can support agency priorities such as:**
**Wounded Warrior**
**Disability and Long Term Care**
**Continuity of care across federal, tribal and community-based health providers**
**Pandemic/Disaster **
**Situational Awareness**
**Post-Market Surveillance of drugs and durable medical goods**
**Bio-surveillance**
**Submission of evidence for disability and claims processing**
**Anonymized clinical data to support research**
**Quality metrics for determining value in health care**
**Emergency response**

**Real World Business Priorities**

- November 14, 2007

## NHIN<>Connect:Connecting federal agencies to NHIN

**Nationwide Health Information Network-Connect (NHIN-C) initiative, a cross-agency collaboration.**
**The NHIN-C initiative articulates a coherent federal strategy to enable the exchange of health information within and with stakeholders**
**NHIN-C Tools**
**The NHIN-C Gateway solution**
- When implemented, a uniform implementation of the NHIN standards and service interface specifications that federal agencies can deploy into their operational environments.
- At the end of the first year of NHIN Trial Implementations, agencies will receive the released gateway solution, a deployable package that includes the NHIN-C Gateway software and an adapter software development kit (SDK).

## Why is this important?

**Why is this important?**

- Wounded Warrior
- Applicants for Disability Benefits
- Emergency response to Pandemic/Natural Disasters

**The secure exchange of interoperable health**
**information serves the needs of the:**

***The Patient is Waiting***