1. S&I Integration with NIEM (DRAFT) Standards Development Support June 8, 2011

2. Objectives of NIEM The National Information Exchange Model (NIEM) is designed to develop, disseminate, and support enterprise-wide information exchange processes and standards that can enable jurisdictions to effectively share critical information in both emergency and routine situations. For the development of Use Cases, ONC would like to leverage the National Information Exchange Model (NIEM) and Information Exchange Package Documentation (IEPD) process and develop a NIEM like process for a Health Care domain. NIEM provides standard definitions in a structured data model, as well as the tools, governance and methodology to execute information sharing in repeatable way that is stable over time. Alignment with NIEM and the development of IEPDs will also support the goals and recommendations put forth in the PCAST report. DRAFT 2

3. NIEM Background Vision: –NIEM is the Standard, by Choice, for Government Information Exchange –Local / State / Tribal / Federal –All aspects of Government Business Driven Focus: –NIEM works by modeling exchanges in business context –NIEM leverages precise vocabularies managed by Communities of Interest –NIEM enables standards for national priority Information Exchanges Critical Success Factor: Growth in Scope & Adoption of Model –Build from Global Justice Information Sharing Initiative –Leverage strong position with States –Work to insure cross-Federal alignment (PM-ISE, Federal CIO Council, OMB) DRAFT Source: DOJ/JMD NIEM Presentation 3

4. NIEM Core Capabilities NIEM includes a set of operational processes and procedures, standards, documentation, tools, training and technical assistance Documentation- - Introduction to NIEM - Concept of Operations (CONOPS) - User Guide - NIEM Naming and Design Rules Standards- - IEPD requirements specs Training and Technical- - NIEM website - Training materials Tools- - Information exchange mapping and modeling - IEPD generation Governance and Processes- -The structure to manage and maintain NIEM and the processes and procedures behind its operations. DRAFT Source: DOJ/JMD NIEM Presentation 4

5. NIEM Concept of Operations NIEM Core (a collection of namespaces) Intelligence Transportation Justice Universal Common NIEM Participants: (3)Bring domain content to NIEM (4)Conform to NIEM architecture Domain specific Core Homeland Security NIEM Participants: (1)Harmonize key data entities (2)Agree to NIEM governance (3)Build & Reuse Information Exchange Package Descriptions Source: DOJ/JMD NIEM Presentation DRAFT 5

6. Healthcare Domain Today, NIEM does not include a Healthcare domain. However, NIEM provides an approach that will help develop consistent descriptions of initiatives and help the healthcare stakeholders. ONC would like to establish a NIEM-like process for health care, and develop and support healthcare specific tools to meet the unique needs of the ONC communities and the privacy and security concerns of healthcare consumers. Human Services DRAFT 6

7. NIEM Alignment The S&I Framework will coordinate with NIEM without being disruptive to NIEM. We will look to the model provided with the development of the Maritime NIEM domain where Maritime operated independently but coordinated well enough with NIEM that NIEM could eventually extend and include the Maritime domain. Establishment of a Healthcare domain has tremendous possibilities in terms of opening up health information to be part of exchanges at the Federal, State, Local, Tribal and potentially, one day at the Global levels. DRAFT 7

8. NIEM Integration Alternatives One option ONC may select to move forward with NIEM is building upon the HL7 Reference Information Model (RIM) or potentially the Federal Health Information Model (FHIM). The main issue to overcome in the HL7 RIM approach is determining how to serialize the RIM classes to a NIEM compliant XML schema. XML serializations exist and are routinely generated from the RIM for purposes of publishing ballots. Schematrons are used for this purpose. However, that does not mean that they will be NIEM compliant. Use of the FHIM requires definition of a new set of foundation classes which in the end may greatly resemble the RIM—which begs the question why not start with the RIM? (and ISO standard?)… DRAFT 8

9. Next Steps Representatives from the S&I Framework, HL7 and the contractor performing an initial NIEM analysis have engaged in initial discussions on a recommended integration approach (J. Quinn, G. Grieve, K. Boone, J. McKim, S. Wagner, C. Mead). Further discussions are required to fully understand the complexity of the data model extensions needed to the NIEM core. These discussions need to include DOJ/DHS. These discussions will likely start with the following statement…For NIEM, it is more straightforward to integrate a new system or data model with NIEM than trying to map or organize an existing and well-defined data model to conform with NIEM. In the situation of an existing data model, a type of abstraction structure might be best suited to handle any nuances between the health information and NIEM. Define a detailed go forward plan from these discussions DRAFT 9

10. Integrate into S&I Artifacts – Deliver to S&I Repository Next Steps Summary Process DRAFT 10 NIEM IEPD Final Decision: Approach for Integration (or not) into NIEM Discussions with NIEM experts and stakeholders e.g., - ONC - ONC Contractors - DOJ/DHS - HL7 TSC Define data model options (health core, abstractions, extensions) Present health domain options to ONC

11. Integration Risks, Complexities and Considerations A core issue in looking at how health information can or cannot fit into a NIEM core is the realization that NIEM value sets are flat lists while health information is hierarchical and linked. Integration with an existing data model vs. a new data model. DRAFT 11