Kantara HIAWG Teleconference

Date and Time

• Date: Thursday, August 18, 2011

• Time: 10am PST | 1pm EST | 5pm UTC | 7pm CEST (Time Chart)

Attendees

• Barry Hieb
• Mickey Tevelow
• John Fraser
• Carlos Garcia (guest from UHG)
• Laurie Tull
• Bob Pinheiro
• Pete Palmer
• Myisha Frazier-McElvenn
• Dazza Greenwood
• Dan Combs
• Rick Moore
• Anna Ticktin
• Lara Zimberoff

Apologies

• No Apologies

Agenda

1. Intro
   1. Roll Call
   2. Approval of Minutes
2. PIDS Document (draft)
   1. Review
   2. Edits and input by Thursday, 8/24
3. Next Steps
   1. Discussion of Launch PIDS ?1.5
   2. Participation Commitments
4. Events - PIDS promotion and adoption
   1. In planning
   2. HIAWG input on other possibilities
5. Other Business
6. Adjourn

Minutes

1. Intro

- Roll Call: See above

- Motion to approve 7/7 and 7/21 minutes by John Fraser, seconded by Rick Moore. 7/7 and 7/21 minutes approved without objection.

2. PIDS Document (draft)

Dazza Greenwood: sent out the next version of the design document prior to call. What you’ll see is some new content and we’ve also separated out the parts dealing with future phases after the design phase. We’ve added in the discussion diagram that we presented to the group last meeting.

Dan Combs: Feedback from the group suggested that it would be beneficial to include some history in the document and to build on the tremendous amount of work that had been done previously. We included a background, or summary section, as well as a much longer section in the appendix that lays out more information about different initiatives and previous projects that led to the development of this particular project. Hopefully it will gives readers insight into the tremendous amount of work that has led us up to this. We hope that you will take a good look at these sections and provide input about these new parts of the document.

Dazza Greenwood: One of the most important differences in the document is that we’ve taken all of the project planning and discussion of standing up the working code into a companion document, which is currently called “future phases,” dealing with coding and legal issues, etc. Our thought was to basically to connect our design document to some of these future phase documents by linking to them to give us a ramp to the next phase.

Barry Hieb: It would be very helpful if a document like this could come out electronically at least 24 hours before the calls.

Dan Combs: We apologize. Mainly on the call today we wanted to present the highlights, collect your feedback over the next week or so, then incorporate the revisions before the next call.

John Fraser: One of the interesting things is the overall architecture. Is there a description of the architecture that you can verbally communicate to the group?

Dazza Greenwood: We’re looking at OpenID for one of the supported identifiers, largely for the user logins. The other major aspect is Shibboleth. When you start looking at the Shibboleth assurance profiles, it’s much easier to conceive the crosswalk into the framework.

John Fraser: Just to summarize the technical architecture, the consensus is OpenID Connect with a Shibboleth backend that can assign the SAML assertions. Is that the package, if you will, that we’re thinking of getting running?

Dazza Greenwood: Correct. FYI we’re not quite finished with the architecture diagrams.

Dan Combs: One issue we keep encountering, and one of the reasons we started separating out the documents is that the design document generally is architectural, and the challenge is separating the architecture design and implementation design and still successfully telling the story.

Barry Hieb: It would be helpful to add one of more specific use cases choosing a specific set of components and scenarios. Those use cases can tie things together.

Dazza Greenwood: Unlike most account systems that have an identifier, what we do in this open architecture is have a place for a number of identifiers. The user will insert the relevant identifiers. We break it down by allowing the user to incorporate the appropriate identifiers that they have. The extent to which PIDS is implemented by a provider that is behind NHIN or has backend systems to connect records, a lot of the patient access would happen on the backend.

Barry Hieb: What we have just been talking about is the core functionality of health information exchange.

John Fraser: I agree with Barry that the HIEs are already resting with this issue, and the big issue sitting in the middle is a patient index. The good thing in MN is that there is a functional HIE here, we have models for how the system is working. We have the ability to pilot something fairly quickly that will flesh out a lot of these issues.

3. Next Steps

Dazza Greenwood: Are there HIEs where we can get a commitment from a contact to launch phase 1.5? We can only start to address these issues by attempting to implement.

John Fraser: One thing I want to emphasize are the Health Insurance Exchanges. They’re becoming extremely large projects by states. The individual patient is expected to log in to a Health Insurance Exchange, so I would add that to the plan as a use case.

Dan Combs: We’ve included it in our discussions but the adding a specific use case is a really good idea.

Dazza Greenwood: A new section in the Phase 1.5 document should be added and include which states we are targeting.

Pete Palmner: Are these HIXs going to exist in the Affordable Care Act is struck down by the Supreme Court?

John Fraser: The feeling in the community is that most of the money for HIXs will be issued to the states before the rule is made.

Dan Combs: One of the things I’m curious about is that it seems the effort to develop HIEs and HIXs are for the most part completely separate.

John Fraser: The HIX efforts are very early and are primarily focused through state insurance. Medicaid is another key player. Part of the way Medicaid will acquire new enrollees is through the HIXs. I wouldn’t say the HIXs are separate from the HIEs, because they are going to have to interoperate.

Barry Hieb: It would be interesting to hear Carlos from UHG’s perspective.

Carlos Garcia: A lot of these discussions that you’re having are relevant to the implementation discussions that we’re having.

4. Events - PIDS promotion and adoption

Dan Combs: We are going to be initiating conversations about participation commitments. Regarding events, we wanted to get your input about building the community and promoting participation and use of PIDS. Part of that will be having events, making presentations, getting on agendas about the project, etc. We are working to put together events, perhaps involving Ray Campbell from Mass Health Data Consortium. I’ve also begun conversations with the University of Texas, Center of Identity about an event focusing on identity in healthcare. We are looking for other opportunities, such as the upcoming HIMSS annual conference.

John Fraser: I think the next important step is for everyone to submit their feedback to eCitizen on the document.

5. Other Business

No other business discussed.

6. Adjourn

Meeting adjourned.

Next Meeting

• Date: Thursday, September 15, 2011

• Time: 10 am PDT | 1 pm EDT | 5 pm UTC | 7 pm CEST
• Dial-In: +1-201-793-9022
• Code: 4630912