2. Policies, practices and technologies… …that enable and promote trusted exchange… …within and across state lines... …among unaffiliated organizations… …and the consumers they serve. A little about NATE…

3. Who Is NATE? NATE’s Membership is Open to Government Entities, Non-Government Organizations, Associations and Individuals NATE is a 501(c)(3) Mission Driven Organization Focused on Enabling Trusted Exchange that Includes the Patient

4. NATE Membership: Consumer Controlled Apps, States, National Associations and International Peers

5. Collaborations and Partnerships

6. Announcing Our Newest Member “Participating in NATE allows VA to continue to be a national leader in enabling our Veteran patients to take control over their health information and become informed and active partners in their overall healthcare.” -- Dr. David Shulkin, Under Secretary for Health U.S. Department of Veterans Affairs Those That Take Consumer Engagement Seriously Join NATE

7. A little about what we do…

8. What is the NBB4C? We Make It Easier to Share Health Information With Consumers So That They Can Do What They Want With It

9. NATE Blue Button for Consumers (NBB4C) Consumer Controlled App Members

10. Jumping the Chasm from Provider-Centric Exchange to Consumer-Centric Exchange  CEs must comply with HIPAA  CEs constrained to permitted purposes of use  CEs spend 95% of their time working with health data  …  Direct functionality  CFAs must comply with FTC regulation  Consumers can do anything they want with their data  Consumers spend less than 5% of their time with health data  …  Direct functionality Wouldn’t It Be Convenient If There Were A Way To Address This?

11. Individuals’ Right under HIPAA to Access their Health Information 45 CFR § 164.524 NEW GUIDANCE FROM THE HHS OFFICE OF CIVIL RIGHTS… 1.A provider who has Direct (all MU2 CEHRT has Direct) is expected to be able to send messages to a consumer who has a Direct address, at the consumer’s request NATE’s bundle makes it easier to do this. Providers only need to request that their HISP enable this capability by subscribing to the NATE NBB4C. Subscribing to the NBB4C is free to providers and includes only consumer controlled apps offering Direct based exchange to consumers 2.A provider who fails to respond to a consumer’s request to have their PHI sent by Direct secure messaging is in violation of the HIPAA Privacy Rule Essentially, they are perceived as engaged in information blocking 3.A provider using Direct at the consumer’s request has no more liability when he exchanges with a consumer than when he uses Direct to exchange with another provider If there is a breach on their side of the transaction, they are culpable, but once it is delivered to the consumer’s side they can no longer be held accountable in the event of a breach

12. New for 2016

13. TrustHarbor Working in collaboration with the FHIR Foundation and other stakeholders, NATE will begin work on this emerging mode of consumer mediated exchange later this year.

14. Predictions for the Future

16. Hospital Academic Med Center Small Practice Veterans Affairs Behavioral Health Long-term services and supports Vision for Learning Health Data Ecosystem Bench Research Provider EHRs Consumer App Research and Public Health Databases Diagnosis Rx Scripts X- Rays Labs Patient Reported Data Patient Consent NIH/Grantees CDC/Public Health FDA/Pharma Backbone of Data Ecosystem  Data Access, Privacy, and Security  API Framework  Movement of Data  Common Standards and Structure (e.g. FHIR)  Common Terminology for Data Content

17. NATE-trust.org Aaron.Seib@NATE-trust.org Sign Up on NATE’s Website to Stay Informed:

18. Comments … Questions …