Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 20.00 - Health Information Exchange › Section 20.04 - Definitions

Current through Register 1525, July 5, 2024
As used in
				101
				CMR 20.00, unless the context requires otherwise,
				terms have the following meanings.
Admission Discharge and Transfer Messages
				(ADTs)
. Types of messages that can track a patient's transitions
				in or out of a site of care such as admissions, discharges, or transfers. The
				focus of ADT messages is to convey data related to patient demographics and/or
				to health care encounters.
Business Associate
. Has the meaning
				assigned to it in
				45
				CFR 160.103 (Health Insurance Portability and
				Accountability Act (HIPAA) regulations).
Certified Event Notification Service
				Vendor
or
Certified ENS Vendor
. An ENS
				vendor that is certified by EOHHS.
Direct
or
the Direct
				Standard
. Refers to the specifications developed by the direct
				project, a nationally recognized organization that develops specifications for
				a secure, scalable, standards-based way to establish universal health
				addressing and transport for participants (including providers, laboratories,
				hospitals, pharmacies, and patients) to send encrypted health information
				directly to cryptographically validated recipients over the Internet. For
				purposes of
				101
				CMR 20.00, references to direct, the direct standard,
				or the direct project will include any other national, open, industry standard
				supported by the Mass HIway.
Electronic Health Record (EHR)
. A
				digital version of a patient's paper chart. EHRs are real-time,
				patient-centered records that make information available instantly and securely
				to authorized users, often including a patient's medical history, diagnoses,
				medications, treatment plans, immunization dates, allergies, radiology images,
				and/or laboratory and test results. EHR systems are able to share patient
				information with other authorized health care providers and
				organizations.
ENS Recipient
. A provider that has a
				contractual relationship including, but not limited to, a business associate
				agreement, with a certified ENS vendor(s) for treatment or care coordination in
				accordance with
				101 CMR
				20.11.
EOHHS
. The Executive Office of Health
				and Human Services, established under M.G.L. c. 6A.
Event Notification Service (ENS)
. A
				service that provides real-time alerts about certain patient medical service
				encounters, for example, at the time of hospitalization, to a permitted
				recipient with an existing treatment relationship to the patient, such as a
				primary care provider.
Health Information Exchange (HIE)
. The
				transmission of health care-related data among providers and payers of personal
				health records according to national standards; the reliable and secure
				transfer of data among diverse systems and access to and retrieval of data. HIE
				incorporates many forms of communication methods including, but not limited
				to:
(a) directed exchanges;
(b) queried exchanges; and
(c) consumer exchanges.
The Mass HIway operates a statewide health information exchange
				in accordance with M.G.L c. 118I, and
				101
				CMR 20.00. More detailed information regarding the
				functions and services provided by the Mass HIway can be found in the
Mass HIway Policies and Procedures
.
Health Information Service Provider
				(HISP)
.
(a)
HISP
. An entity that, as part of
				or all of its business, performs the following:
1. verifies participant identities;
2. issues and manages security keys;
3. issues direct addresses; and
4. processes messages to and from those addresses using the
				direct standard.
(b)
HIway Trusted HISP
. A HISP with
				which the Mass HIway has a direct contractual arrangement, or a HISP that
				belongs to a third-party organization that acts as a trust framework aggregator
				with which the Mass HIway has a direct contractual arrangement, to securely
				exchange Direct Messages, through a means typically referred to as a
				HISP-to-HISP connection.
(c)
HISP-to-HISP Connection
. A
				technical connection between two or more HISP systems for the purpose of
				delivering Direct Messages to and from authorized participants of the HISPs
				that contains clinical or administrative health information about a specific
				patient. Contractual agreements establish the HISP-to-HISP terms and may be
				between two HISPs or may be between a HISP and a third-party organization that
				acts as a trust framework aggregator.
HIway Direct Messaging
. A secure
				method for Mass HIway users, including provider organizations, to transmit a
				message with information about a patient to other users, where the Mass HIway
				does not analyze, use, or share the contents of the message except as required
				to deliver it and to make it available for use by the intended recipient. HIway
				Direct Messaging follows the direct standard for encryption technology, or its
				successor standard, and provides a more secure method of transmitting
				information than other modes of transmission such as sending a fax, or sending
				information by postal mail.
HIway-facilitated Service
. A service
				whereby the Mass HIway creates a framework for protected health information
				exchange through governance, promotion, certification, and/or contracts with a
				vendor or vendors to support treatment or care coordination.
HIway-sponsored Services
. A service
				for HIway participants whereby the Mass HIway operates and manages a technology
				platform that allows the HIway to may use, analyze, and/or share protected
				health information and/or personally identifiable information on behalf of
				participants.
Mass HIway Integrator
. An organization
				that connects HIway participants to the Mass HIway. Mass HIway integrators are
				business associates of participants and may include electronic health record
				(EHR) vendors, technical integrators, and regional health information
				organizations (RHIOs). Mass HIway integrators use Mass HIway for HISP
				services.
Mass HIway User
. A user
				includes:
(a)
HIway Participant
. A provider
				organization, a health plan, or a business associate of either a provider
				organization or health plan or other entity approved by EOHHS. HIway
				participants must execute a Participation Agreement.
(b)
Non-participant User
. An
				organization that is granted access to the Mass HIway through a HIway trusted
				HISP.
Patient Matching Process
. A certified
				ENS vendor's proprietary algorithmic process(es) used to match ADTs with
				patients.
Reflection
or
Reflect
. The process certified ENS vendors use to
				disclose ADTs with all other certified ENS vendors for treatment or care
				coordination.
Statewide Event Notification Service (ENS)
				Framework
. An event notification service framework created as a
				HIway-facilitated service by the EOHHS under
				101 CMR
				20.11.
Trust Framework Aggregator
. A trust
				framework aggregator manages a bundle of security certificates, or "Trust
				Anchors", to facilitate interoperable direct exchange between HISPs in a
				uniform and scalable manner that is consistent with industry best practices for
				security and trust, thereby avoiding the need for further one-off negotiations
				between relying parties who are participants in the bundle.
Use Case
. A narrative that describes
				how to accomplish a business goal and sets forth the functional requirements
				including scope of the activity, people and organizations involved, expected
				inputs and data, processing steps, and anticipated results. The use case
				informs the technical and process planning for development of a solution, and
				can be implemented between two provider organizations or multiple provider
				organizations based on the business need, clinical workflows, and technical and
				operational readiness. Categories of use cases will be detailed in the Mass
				HIway Policies and Procedures as updated from time to time, and may include,
				but not be limited to, the following categories:
(a) Provider-to-provider Communications;
(b) Payer Case Management;
(c) Quality Reporting; and
(d) Public Health Reporting.