esMD Author of Record L1 Use Case Kick-Off Meeting Friday, July 20, 2012

Meeting Etiquette Please announce your name each time prior to making comments or suggestions during the call Remember: If you are not speaking keep your phone on mute Do not put your phone on hold – if you need to take a call, hang up and dial in again when finished with your other call –Hold = Elevator Music = very frustrated speakers and participants This meeting, like all of our meetings, is being recorded –Another reason to keep your phone on mute when not speaking! Feel free to use the “Chat” or “Q&A” feature for questions or comments NOTE: This meeting is being recorded and will be posted on the esMD Wiki page after the meeting From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute 2

Use Case Overview Agenda AgendaPresenterTime Frame General Welcome and Introductions Initiative Timeline Overview of Use Case process within S&I UC Outline Overview Presha Patel2:00 – 2:15 AoR Use Case Refresher of UC 1 and UC 2 Context Diagrams Draft AoR Context Diagram Areas to Address Draft Scope items Introduce Subworkgroups Presha Patel Bob Dieterle2:15 – 2:50 Wrap Up Weekly schedule moving forward Next Steps Support Team Contact Information Presha Patel2:50 – 3:00 QuestionsAll 3

esMD Initiative Timeline 4 Author of Record WG Use Case and Requirements L1 Pilots (TBD) SDS Structured Content WG (Use Case 2) Use Case #2: Sending eMDR Outline Use Cases & Stories Harmonization/ Standards Analysis of Registration Harmonization/ Standards Analysis of eMDR Use Case #1: Registration Combined Registration/ eMDR Pilots (TBD) 11/30-12/7 Charter Consensus Pre-Discovery Initiative Charter/Scope Today (7/20/12) Oct ‘11 Kick-Off/ F2F Oct ‘12 Jan ‘12April ‘12 July ‘12 PPA Workgroup (Use Case 1) Pre-Discovery Harmonization L1 AoR Workgroup Through April 2014 Kick-Off

Use Case Development within S&I Framework 5 Tools and Services Use Case Development and Functional Requirements Standards Development Support Standards Development Support Certification and Testing Harmonization of Core Concepts Implementation Specifications Pilot Demonstration Projects Reference Implementation Architecture Refinement and Management We are Here

Use Case Development Objectives Engage Stakeholders as Committed Members, Invited Experts, or Interested Parties in the creation of a Use Case Identify Use Case(s), Scenario(s) and User Stories that address real-world problems There can be multiple Use Cases There can be multiple Scenarios (and subsequently User Stories) within one Use Case Keep it simple Create a finalized Use Case that demonstrates value and supports the proposed goals for the Initiative Publish a finalized Use Case that contains necessary content to enable Harmonization and subsequent S&I Framework efforts to occur Establish the Use Case and supporting artifacts in a reusable fashion to support future S&I Initiatives 6

Use Case Outline Note- This is tailored for each Initiative Preface and Introduction 2.0 Initiative Overview 2.1 Initiative Challenge Statement 3.0 Use Case Scope 3.1 Background 3.2 In Scope 3.2 Out of Scope 3.3 Communities of Interest 4.0 Value Statement 5.0 Use Case Assumptions 6.0 Pre-Conditions 7.0 Post Conditions 8.0 Actors and Roles 9.0 Use Case Diagram 10.0 Scenario 1, 2, x… 10.1 User Story 1, 2, x, … 10.2 Activity Diagram Base Flow Alternate Flow 10.3 Functional Requirements Information Interchange Requirements System Requirements 10.4 Sequence Diagram 11.0 Dataset Requirements 12.0 Risks, Issues and Obstacles Appendices Related Use Cases Previous Work Efforts References Leverage from Charter

Use Case Development Process 8

S&I Community Enabling Toolkit (CET) – Use Case Overview 9 Link -

esMD PPA UC 1 Refresher Provider Registration with a Payer (CMS User Story) 10

esMD UC 2 Refresher Secure Transportation and Contents of eMDR (CMS User Story) 11

Author of Record Level 1 12 Level 3 Digital signature to allow traceability of individual contributions to a document (Build upon Level 2) Level 2 Digital signature on an individual document (Build upon Level 1) Level 1 (Current Focus) Digital signature on aggregated documents (Document Bundle)

Provider Entity Payer Entity AoR L1 – Draft Context Diagram Digital Identities and Bundle Level Signatures Payer Provider (Individual or Organization) Provider (Individual or Organization) Contractors / Intermediaries Agent Payer Internal System Gateway esMD UC 2: Secure eMDR Transmission esMD UC 1: Provider Registration esMD AoR Level 1 Digital Identities Bundle Signatures Certificate Authority Registration Authority External Provider Directories External Provider Directories 13

Areas to Address Use Case TopicUC1: RegistrationUC2: eMDRAoR L1 Bundle Identity Proofing Required Digital Identity Management Required Digital Signatures & Signature Artifacts Required Delegation of Rights RequiredNot RequiredOptional PHI Encryption Not ApplicableRequiredTBD Other Topics Characteristics of solution Non-Repudiation* Required Characteristics of solution Data Integrity** Required Provider Directories Required TBD 14 *Non-repudiation (NIST) - Non-repudiation is a service that is used to provide assurance of the integrity and origin of data in such a way that the integrity and origin can be verified by a third party. This service prevents an entity from successfully denying involvement in a previous action. **Data Integrity (NIST) - Data integrity is a property whereby data has not been altered in an unauthorized manner since it was created, transmitted or stored. Alteration includes the insertion, deletion and substitution of data.

Scope AoR (L1) In Scope Identify Proofing as part of Non- Repudiation of Actor Identity Digital Credential Management required for Non-Repudiation Actions (Signing and Delegation), Data Integrity and Encryption Digital Signatures and Signature Artifacts for Identity and Non-Repudiation Digital Credentials and Artifacts for Non- Repudiation of Delegation as required by UC1 and AoR L1 Data Integrity requirement actions and artifacts Encryption of PHI requirements Interactions with External Provider Directories Out of Scope Interactions between: Payer and Payer Contractors Provider and Agent Payer or Payer Contractor and Gateway Transaction level encryption Document level signatures and individual contribution signatures Defining delegation of rights within and between Providers and other authors 15

User Story Components / Workflow / Sub-workgroups (4) 1. Identity Proofing Federal Bridge / NIST Level 3 Individual and Organization Proof of identity requirements Allowed proofing processes 2. Digital Credentials Issuance Credential types and forms Credential uses (Identity, Signing, Proxy, Encryption, Data Integrity) Specific use credentials (e.g. Direct) Maintenance requirements Revocation 3. Signing Transaction and AoR L1 Workflow Artifacts 4. Delegation and Proxy Credential approach Delegation process Use and limitations on Use Revocation Note - Sub-workgroup leaders, charge, meeting schedule, and deliverables is TBD at this time 16

User Story -- Additional Components / Workflow Provider Directories (required for entire initiative) Information requirements Interactions (transactions) Entry validation standards Use and limitations on use esMD Policy Issues (following report from SWG 1-4) Requiring digital identities Requiring digital signing of transactions Requiring digital signing of submission Implications of attestation Other General Issues Non-repudiation Data integrity PHI encryption 17

User Story / Workflow Overall User Story Components 1)All Actors obtain and maintain a non-repudiation digital identity 2)Provider registers for esMD (see UC1)* 3)Payer requests documentation (see UC2)* 4)Provider submits digitally signed document (bundle) to address request by payer *User Stories for UC 1 and 2 have already been defined. Workgroup will help define bullets 1) and 4) 18

SUNDAYMONDAYTUESDAYWEDNESDAYTHURSDAYFRIDAYSATURDAY *Schedule and Timeline is subject to change AoR Use Case Schedule and Timeline* Note – Weekly Meetings on Wednesdays and Fridays July 2012 Use Case Kick Off UC Overview Context Diagrams Areas to Address In-Scope/Out-of-Scope Introduce SWG 19 HW items for 7/24 Review and provide feedback on 7/20 discussion Review HW items Communities of Interest Glossary of Terms Actors & Roles User Story Review 7/25 items User Story Cont. Assumptions Pre Conditions Post Conditions HW items for 8/1 Review and provide feedback on 7/25 & 7/27 discussions

Drafted Sections for Review and Feedback Review + Provide feedback on Draft Context Diagram – Review + Provide feedback here on In-Scope / Out-of-Scope items – Scope+and+Out+of+Scopehttp://wiki.siframework.org/AoR+Use+Case+L1+-+In- Scope+and+Out+of+Scope Review Only - Approach for the 4 Subworkgroups for a more in depth discussion next week 20

Next Steps / Reminders The esMD Wiki structure has been revised recently. Please use the below links for easy access to AoR workspace –Charter –Use Case Homepage – Workgroup Meeting Schedule for AoR L1 Use Case –Wednesdays: 1:30 – 3:00 pm ET and –Fridays: 2:00 – 3:00 pm ET Review and provide feedback for Context Diagram and Scope by 12:00 noon ET on Tuesday 7/24 21

Contact Information 22 For questions regarding the Use Case, please contact your support leads Coordinator Sam Elias: Workgroup Leads Technical Lead - Dan Kalwa: Workgroup Co-Lead - Bob Dieterle: Workgroup Co-Lead - Mark Pilley: Project Management: Sweta Ladwa: Adjoa Degbo: Use Case Development: Presha Patel: