1. Office of Science & Technology Update April 17, 2013 Doug Fridsma, MD, PhD, FACP, FACMI Chief Science Officer & Director, Office of Science & Technology

2. S&I Framework Operating Metrics Timing Outputs Participation & Process Framework Launch DateJan 7, 2011 First Initiative Launch DateJan 31, 2011 Elapsed Time (as-of today) 27 months # Consensus Approved Use Cases16 # Pilots Committed34 # Pilot Vendors42 Total Ballots11 # Total HL7 Ballot Comments Received 3,128 # HL7 Ballot Comments Resolved2,415 # Wiki Registrants2243 # Committed Members706 # Committed Organizations537 # Working Sessions Held1,460 S&I Face to Face meetings3 Standards Organizations engaged 35 SDS Newsletter Subscribers201 As of 4/4/2013 2

3. S&I Framework Pilots S&I Pilots website S&I Pilots website indicates geographically where all pilots are located 3

4. Transitions of Care Query Health Pre-DiscoveryUse CaseHarmonizationRI, Test & PilotEvaluation Lab Results Interface Data Segmentation for Privacy esMD Longitudinal Coordination of Care Public Health Reporting Laboratory Orders Interface Direct Project (S&I Archetype) Health eDecisions Automate Blue Button Companion Guide Completed IG/Errata Published, 2014 CEHRT In Progress Pilots Underway, QRDA III Published, HQMF in Comment Reconciliation Pilots in Evaluation, IG in preparation for balloting Community-Led; Consensus for Data Harmonization profiles closed on 1/20/13; community will be meeting on a monthly basis esMD AoR Level 1 IG is now in E2E review; AoR Level 2 UC achieved consensus; IG consensus closed for UC 1, UC 2, and Prov. Dirs. Guidance IGs Community-Led initiative; 1st UC Completed, PAS in Comment Reconciliation, Creating a 'Care Plan' Glossary for HITPC & HL7. Use Case 2: Patient Care Plan LOI IG ballot ended on 1/7/13 and ballot reconciliation conts; Lab pilot efforts include LOI, and eDOS Use Case 1: Knowledge Artifact Sharing Model, Schema and IG was approved by HL7, UC 1 now in Pilots. Use Case 2: CDS Guidance Service achieved consensus Two WGs complete (Payer & Clinical Content); Two WGs (Push & Pull) in progress, at various stages of IG development In production Structured Data Capture Project Charter Consensus complete; Use Case development underway with planned completion in May; Workgroups will be formed after all Use Case elements drafted S&I Initiative Portfolio Snapshot 4

5. S&I Framework Initiatives List 5 Initiative (chronological) Transitions of Care Laboratory Results Interface Provider Directories Certificate Interoperability Query Health Data Segmentation for Privacy Electronic Submission of Medical Documentation Initiative (chronological) Public Health Reporting (Community-led) Longitudinal Coordination of Care Lab Orders Interface Health eDecisions Automate Blue Button Structured Data Capture Prescription Drug Management Program Status Key: Active Maintenance Closed

6. Standards Readiness for Current & Future Stages of Health Information Exchange 6 Develop a Standards Implementation testing Framework to ensure the testability and implementability of standards Continue providing technical resources, such as validation tools to support industry adoption of standards Use Case Development and Functional Requirements Harmonization of Core Concepts Standards Development Support Modular Specifications Standards and Interoperability Testing Platform Standards Implementation Testing Framework Implementation Specifications S&I Framework

7. Modular Specifications Process Authorization Framework Messaging Platform § 170.202(a)(1) and (2) Applicability Statement for Secure Health Transport XDR and XDM for Direct Messaging Development Sprints Public Feedback SME Input Internal Feedback Artifacts Produced: Specification Test Implementation Product Neutral Test Cases Modular Specification Process Direct Based Secure Transport - SMTP and S/MIME Direct Based Secure Transport -XDR and XDM Conversions § 170.202(a)(3) Future Standards from S&I Implementable/testable Standard ready for Regulation Exchange Based Secure Transport - SOAP over HTTP

8. Standards Implementation &Testing Platform – One-Stop Place for Implementers Phase II

9. Knowledge Base http://ccda.sitplatform.org 9 Forum Issue tracker

10. Discussion Forum http://forum.sitplatform.org 10 A moderated Discussion Board is available to field questions from the implementation community and facilitate dialogue, and authoritative responses from experts in the Standards Community.

11. Issue Tracking http://ccda.sitplatform.org/Open+Issues http://ccda.sitplatform.org/Open+Issues 11

12. Content TestingData Sets Sandbox Environment Transport and Content Testing 12 Home Direct Testing General Information Links to Direct Specs TTT Certification Test Link Regulation Tool documentation Links to Direct Specs TTT Certification Test Link Regulation Tool documentation Upload Trust Anchor: C:\TA.der Browse Transport Testing Direct SOAP Direct Send: (Send from Implementers System to Endpoints below: ) Endpoint 1 : Basic Direct Endpoint 2 : Direct with CCDA Validation Endpoint 3 : Direct for MU2 ToC Objective Direct Receive: (Receive Messages from SIT: ) Choose Own Content C:\Sample Text Browse Choose Precanned Content C:\Sample Text Send Message Enter your Endpoint sample@emr.com

13. Summary Knowledge Base: – Ready to provide centralized place for examples, guides, tools, community collaboration, issue tracking, and a testing framework Forums: – Ready to connect implementers with standards experts Issue Trackers: – Ready to facilitate process of preparing systems to interoperate, and making standards implementation ready Sandbox: – Ability to perform pre-certification testing of updated standards 13