1. CONFUSED? DON’T BE. IT’S ACTUALLY REALLY STRAIGHTFORWARD. RICK FREEMAN FEBRUARY 4, 2015 The HSPC Tier 1 & Tier 2 Technical Specification Explained

2. Balancing Vendor Adoption with Multi-Platform Innovation The HSPC Spec needs strong vendor adoption to succeed. Yet, some features required by use cases that span multiple healthcare organizations or other advanced clinical use cases vendors are either unable or hesitant to support. Enter the two tiered HSPC spec.

3. Tier 1 HSPC Specification GOAL: Create a spec that most vendors can/will implement so most providers have access to a Tier 1 HSPC certified platform. Ubiquity is the goal. Creates a large distribution channel. Encourages application developers to build and distribute HSPC apps.  We wont attract very many app developers if there are limited locations where their apps can be deployed into production. As vendors become capable or willing to Tier 2 platform features, these features can be promoted to Tier 1.

4. Targeted Features of Tier 1 FHIR Data Services  Governed by HSPC FHIR Profiles (collaboration with Argonaut is a goal). SMART on FHIR User Authentication SMART on FHIR Application Launch Context Support for applications that run outside of a specific user context.  E.g. Apps triggered by events. Simple Eventing & Alerting Integration into existing EHR workflows.  Apps will launch inside an existing EHR workflow. User Notification & Messaging

5. Tier 2 HSPC Specification GOAL: Allow for innovation for use cases that involve multiple healthcare organizations or that moves beyond the capabilities of existing EMR and EHRs. Ultimately, HSPC is a provider led consortium, Tier 2 is for features that a single EMR vendor are either unable or reluctant to support yet are needed to support advanced clinical use cases. The Tier 2 spec builds on top of Tier 1. In other words, Tier 2 platforms require an implementation of a Tier 1 platform. Some Use Cases Tier 2 address include:  Use cases that span multiple EMR and EHRs.  Care Coordination between independent platforms. Referrals & Scheduling Workflows between separate healthcare organizations.  Population Health Management and Analytics  Clinical Workflow modeling and orchestration of Tier 1 & Tier 2 services.

6. What about these HSPC Sandboxes? There are two different types of sandboxes 1. Application Development Sandbox The purpose of these sandboxes is to provide a fully functional, EMR neutral implementation of the Tier 1 and Tier 2 platform specification to enable the rapid development of clinical apps.  Changes to the features of the platform will be infrequent, well communicated, and of only stable releases.  Will contain clinical data representative of real world medium to large scale EMR implementations. 2. Platform Advancement Sandbox The purpose of these sandboxes it to provide an environment where proposed or exploratory Tier 1 or Tier 2 platform features can be developed and tested.  Provides a location for multiple organizations to collaborate on experimental platform features.  Platform features can be vetted before being officially proposed for specification inclusion.  Insulates Application developers from frequent platform changes.

7. What is the status of the sandboxes? Application Development Sandbox Tier 1 -- We just launched the Tier 1 HSPC Application Development Sandbox! Go use it.  Stay for the next session for a detailed overview and tutorial on how to get started.  This afternoon, we’ll sit down and help you punch out some code to get you started.  The developer’s guide is here.developer’s guide is here  What you need to know:  The test data is very limited at the moment. Current priority to populate it with realistic data and to build tools to make it easy for app developers to populate custom data.  Not all FHIR resources are supported yet. Coming soon. See the JIRA project for the roadmap and vote up the ones you need.JIRA project  The HSPC FHIR Profiles are still being developed. See the Modeling and Terminology roadmap in JIRA.JIRA Tier 2 – The Tier 2 HSPC Application Development Sandbox is expected later this year.

8. What is the status of the sandboxes? Platform Advancement Sandbox Tier 1: No concrete plans for it at the moment. Will be created once there is a need.  Tier 1 sandbox implementation resource requirements are small, installs and configures very quickly, runs easily on a laptop, and requires no fee based software to run (all open source). Tier 2: Planned for later this year.  Resources required to run it will most likely be too much for a standard developer machine. The install and configuration will most likely require specialized knowledge. The software backing the sandbox will most likely require a relatively expensive license.

9. What about the HSPC App Store? It’s central to the mission and vision of HSPC. Where is it?  Work has yet to begin… But, it’s next on the roadmap for 2015. GOAL: HSPC App Store fully functional and open for business by SXSW Interactive 2016 and HiMSS 2016. There is a lot to figure out.  Certification Testing (Will vendors require an extra certification?)  Hosting  Deployment  Payment model & commission.  Security  Customer support model What’s next?  Need a committee and resources dedicated to building the app store and working through all the process and legal mumbo jumbo.

10. OKAY, SO MAYBE IT WASN’T ALL THAT STRAIGHTFORWARD. Q & A