DPROV Pilot RAIN Live Oak Network California Inter-HIE DPROV Pilot S&I Framework Date: 08/05/2015

Agenda Introduction Goal of Pilot Standards for Consideration Logistics Ecosystem Considerations Resources/References

Introduction: Organization. RAIN Network has been an active member of the California HIE and telemedicine community for 25 years, focusing on rural and high-needs communities to have the greatest impact on the quality of healthcare in California. RAIN Network is currently a HISP providing Direct Exchange and Directory services to healthcare providers and patients across the country. In the last two years we have also been closely involved in California's Statewide Directory Service project and served on the California Trust Framework pilot which resulted in the adoption of the CALDURSA and CTEN policy Statewide. RAIN's Direct Exchange is an extremely flexible platform for data transport and is a tested exchange partner with CA-HIE HIE’s. Currently our partner HIE Networks provide services throughout the State which have a variety of levels of data provenance in place locally. Bringing those local efforts together to create a fully interoperable exchange of data provenance Statewide is an important next step.

Introduction: Pilot Team Identify the members of your organization who will be supporting this pilot. If possible include the role he/she will play in the pilot and contact information NameRole Timothy Tyndall Project Director Ayami TyndallSystem Engineer

Goal of the Pilot Our goal is to demonstrate the use of data provenance across a variety of California- based HIEs to improve care quality and to accurately track data provenance and origin even after numerous transmissions and passage through different EHR/HIE systems. Our pilot will address Use Case Scenario 2 (see next slide) with RAIN Network's Direct Exchange acting as a transmitter to transport data between participating data sources/end points. By including differing EHR backends/vendors we will show wider interoperability of data provenance and the ability to accurately retain and update data provenance across multiple database ecosystems and after multiple cycles of transport-import-export- transport.

Data Provenance Use Case- Scenario 2 Overview Start Point EHR/Lab/Other End Point EHR Transmitter ONLY (HIE, Other Systems) Transmitter ONLY (HIE, Other Systems) Start Point Transmitter Receives Data Transmitter Forwards Data to End Point End Point Trigger

Standards under consideration For content/ system requirements we are using the following standard(s): HL7 v2 & v3, C-CDA, Other Patient Records Standards For transport/Information Interchange we are using the following standard(s): Direct, HPD v1.5 (With Fed. Option) Do you belong to the SDO that maintains the standards in consideration? If yes which SDOs?: No

Pilot Logistics: In and Out of Scope The primary scope of this pilot will be to demonstrate the inclusion and retention of data provenance. Out of scope will be more in-depth integration of data provenance with secondary services and use of provenance in other types of medical records. Timeline Kick off: August 2015 CA-HIE Participation Committee: September 2015 Begin real-world pilots: November 2015 Completion & reporting: February 2016 Challenges: –Primary challenges will be smooth interoperability of data provenance between different participating data sources using different software and accurate tracking and updating of provenance over time and across varied data environments.

Pilot Ecosystem Current or Potential Partnerships with other pilot(s) or pilot vendors California Association of Health Information Exchanges (CA-HIE) and member HIEs & EHRs Through CA-HIE we will be able to work with several of the largest HIEs in California. We have worked with these organizations in past projects and will be able to work with them to develop code/plug-ins to facilitate data provenance in their data and the use of Direct for exchange. Vendors active in the state available as possible participants: Mirth/NextGen, SureScripts, Epic, Cerner, California Direct, Santa Cruz HIE, Redwood MedNet, OCPRHIO, San Diego HIE, Inland Empire HIE..

Considerations With over two decades of experience RAIN Network is well positioned to organize a DPROV pilot in California. As a member of CA-HIE and the California Trusted Exchange Network (CTEN) we have access to partners and resources across the state which will assist in establishing a successful and wide-reaching pilot demonstration Retaining data provenance across differing systems and ensuring it can be used effectively will be an important step in establishing wider Health Information Exchange Key resources will be access to standards information to assist in accurate inclusion of data provenance and access to any code/plug-in work that has been done to update existing systems to include, write, update and use data provenance fields

Helpful References Data Provenance Use Case: Pilots Wiki Page: