1. Building and Testing a Trusted Agent Data-Sharing Infrastructure Bob Galbraith and Rita Mohsin NBME and FSMB April 17, 2007 www.trustedagent.org

2. Trusted Agent Team  FSMB – Dale Austin, Tim Knettler, Rita Mohsin, Graham Calvert, Elizabeth Miles, Cyndi Streun, Dennison Herger, Bobby Dowling, Kevin Caldwell, Roxanne Huff  NBME – Bob Galbraith, Joe Crick, Kenny Yu, Madhav Iyer, Sue Gebeline, Martin Lambert, Kathie Rose  Ohio State Medical Board – Dianne Thompson, Penny Grubb, Kay Rieve  New Hampshire & Kentucky Board – Penny Taylor and Brenda Knopp  Input from Medbiquitous

3. www.trustedagent.org  Data-Sharing infrastructure  Real time access to data in many repositories  Gathers data specific to function  Report out to authorized viewers  Scaleable, secure and confidential  ONLY functions when authorized by the physician identified by the data What is a Trusted Agent?

4. www.trustedagent.org Trusted Agent General Concept Delivering the right data to the right people at the right time for the right purpose …with the authorization of the individual identified

5. www.trustedagent.org Paper-and-Pencil (20 th Century)  70 licensure jurisdictions had different forms for initial application (even though data elements comparable)  paper-and-pencil  self-reported data, validated later

6. www.trustedagent.org  Common License Application Form (CLAF)  One primary form, common data  Option for state-specific addendum  3 States agreed to Pilot – viz. OH, KY, NH  Streamlining of the Application Process  Data called from repositories through hub  Data already source-verified (by Federation’s Credentials Verification Service FCVS)  CLAF pre-populated with verified data  Real time formatting and submission 24/7 The CLAF Pilot (21 st Century)

7. www.trustedagent.org  Web services architecture  Real-time access to repositories  Independent of system & data base structure  Actual gathering, compilation and report out of data occur only upon authorization of the physician identified. The CLAF Pilot - 2

8. www.trustedagent.org The CLAF Pilot - 3  The Medical Professional accesses CLAF, which requests necessary data from the Trusted Agent Hub  Hub gathers data from FSMB & NBME, and returns to CLAF  CLAF compiles application form and after inspection by the physician, transmits to SMB

9. www.trustedagent.org  Electronic medium/Online  Near real time 24/7  Reduces burden of paperwork  Data pre-population  Increases accuracy and completeness  Reduces burden of data entry  Enables license applications to multiple jurisdictions simultaneously CLAF - Benefits

10. www.trustedagent.org Trusted Agent Hub and CLAF Design  Document/Literal Web Services  All applications and services registered in Trusted Agent – no UDDI  Generic XML schemas for applications and providers interface  Custom XML schemas for data returned from provider  Unique security KEY for each member of Trusted Agent  Data encrypted (using KEY) for service specific request/response  Successful user login to return a time-expired certificate  Service request (except login) requires a valid certificate  Secure VPN communication with applications and providers  SSL based Trusted Agent registration application on internet

11. www.trustedagent.org Technology used: Trusted Agent CLAF  Oracle Application Server 10.1.2.0.2 on Linux  J2EE 1.3  Oracle Database 10.2.0.1.0 with VPD  Java  JDeveloper 9.0.5.2  XML  SOAP 1.1  WSDL 2.0  Oracle Application Server 10g on Solaris  J2EE 1.3  Oracle Database 9i  Microsoft.Net Framework 2.0  C#  Microsoft Server 2003  IIS 6.0  XML/XSLT  SOAP 1.1  WSDL 2.0

12. www.trustedagent.org CLAF/Trusted Agent Hub Interaction

13. www.trustedagent.org Performance of Pilot  Around 1000 medical professionals have interacted with CLAF and TA Hub  100+ completed applications submitted  <1% reported issues on their online survey  Average time (seconds) for round trip web service calls:  1.95 Authentication  1.80 GetPacketStatus  2.63 GetSFCVS

14. www.trustedagent.org Lessons learned from CLAF  More messages on faults/detailed logging  Need to collaborate with business units and state member boards to repurpose data

15. www.trustedagent.org  Queuing of requests & responses  Accounting and e-commerce  Adding biometrics for authentication  Integration with current standards  Matching multiple IDs for applicants  Integrating other compilations & data providers Enhancements:Trusted Agent Hub

16. www.trustedagent.org Enhancements: CLAF  Fault tolerance 24/7  More robust database connections  Custom logging for troubleshooting issues  PDF to be generated by a report (cleaner)

17. www.trustedagent.org Demonstration of Online CLAF

18. www.trustedagent.org Brought to you by: Robert M. Galbraith, M.D. Executive Director, Center for Innovation National Board of Medical Examiners (NBME) 3750 Market Street, Philadelphia, PA 19104-3102 rgalbraith@nbme.org Rita Mohsin Director, Information Services Federation of State Medical Boards (FSMB) PO Box 619850 Dallas, TX 75261- 9850 rmohsin@fsmb.org