1. 360Exchange (360X) Project Provider Directory Workgroup 09/14/2012

2. This meeting is being recorded, if you disagree, please hang-up. If you’re not speaking, please mute your line. Please don’t put us on hold. 1 Reminders

3. Demonstrations of HPD Plus and HPD implementations – Vince Lewis – Peter Bachman Use case walk-thru for PD functionality Next Steps 2 Agenda

4. Demonstrations of HPD Plus and HPD implementations – Vince Lewis – Peter Bachman 3 HPD/HPD Plus Demonstrations

5. 5.1 Referral Destinations PCP knows the specialist PCP does not know the specialist PCP knows the specialist provider organization PCP does not know the specialist provider organization 6.0 Pre-Conditions Provider and specialist do not belong to the same organization Relevant clinical information will be exchanged which will include at a minimum a “core” clinical summary, and may also include “variable” data in the clinical summary and/or additional clinical data in other content types. 9.0 Issues and Obstacles Address kook-up / Provider directories (What if Dr. Bob has multiple addresses? etc.)? Need for Direct/HISP interoperability -- Many Direct implementations to date are effectively ‘closed’ networks that use a common standard because few HIEs/HISPs have agreed to establish trust between themselves and/or provide mechanisms for end-users to manager their own trust relationships. 4 Use case walk-thru for PD functionality

6. 5 Step # ActorEvent/DescriptionInputsOutputsPD Function 1Provider (PCP)Trigger Generation of Consultation Request Clinical Summary for Patient A STARTGenerated Consultation Request Clinical Summary and Optional Additional Clinical Content N/A 2PCP EHR System Send Consultation Request Clinical Summary to specialist's EHR System Consultation Request Clinical Summary and Optional Additional Clinical Content From within the PCP EHR Look-up Direct address for Specialist (org and name) Multiple HISP/PD query 3Specialist EHR System Receive Consultation Request Clinical Summary from PCP's EHR System Consultation Request Clinical Summary and Optional Additional Clinical Content N/A 4Provider (Specialist) View Consultation Request Clinical Summary in specialist's EHR System Consultation Request Clinical Summary and Optional Additional Clinical Content ENDN/A

7. 6 Use case walk-thru for PD functionality Step # ActorEvent/DescriptionInputsOutputsPD Function 5Provider (Specialist) Trigger Generation of Consultation Summary for patient A STARTGenerated Consultation Summary and Optional Additional Clinical Content N/A 6Specialist EHR System Send Consultation Summary to PCP's EHR System Consultation Summary and Optional Additional Clinical Content Consultation Summary and Optional Additional Clinical Content From within the Specialists EHR Look-up Direct address for PCP (org and name) Multiple HISP/PD query 7PCP EHR System Receive Consultation Summary from specialist's EHR System Consultation Summary and Optional Additional Clinical Content N/A 8Provider (PCP)View Consultation Summary in PCP's EHR System Consultation Summary and Optional Additional Clinical Content ENDN/A

8. Scoping for 360X PD Workgroup TopicDiscussion on 08/03/12 WG CallIn Scope Out Scope GrpSeq. 1Internal PD query (within the senders EHR or HISP) Simple Direct address look-up, returns address, org or individual, if not found, query external PDs. X12 2External PD query (outside the senders EHR of HISP) Simple Direct address look-up, returns address, org or individual, query external PD(s), full federated or centralized PD. X12 3Query for Address1.1. Can return individual or organizational addresses 1.2. Can return multiple addresses 1.3. Cross PD lookup is optional 1.4 This WG will define Minimum Data Set (separate topic) XXXXXX 22 4Query for CertificateDirect certificates (vs authentication)X22 5Minimum data setX32 6Query for Interoperability and Payload Capability of the Edge System (ESI Discovery) Will this be necessary for this use case if a minimum data set is defined? ?2 7Authentication (Between Provider system and the PD) Use of Direct certificates (see 4). FBCA/L3 Cross Certified certs for authentication (parking lot, community policy issue) ? 8Edge System (EHR, EMR, or a HISP querying the Provider Directory) The guidance from this work group should be edge system independent? X5 9PD Entity (EHR, EMR, HISP, HIE, State) PD could be any or combination of EHR/EMR, HISP, HIE or a State level PD) X5 10PD Data Maintenance (Identification and Vetting Process) Rely on the vetting processes of the PDs (Could be HISPs, Large Organizations or the State or Federal level PDs) (parking lot, community policy issue) ? 11Provider Directory Standards (HPD or HPD+) Refer to existing standards and documentation. Provide link to HPD+ specifications X51

9. Leads to draft possible recommendations Next meeting, same time and place. 8 Next steps…