1. Federal Health Architecture Roadmap and Work Products Mary Forbes Office of the National Coordinator for Health IT August 5, 2004

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3. 2 Key Drivers and Influences President –President’s Management Agenda –National Health IT Coordination - Goal to establish Electronic Health Records (EHR) for most citizens within 10 years OMB –Federal Enterprise Architecture (FEA) program and the FEA reference models –Direction and authorization to develop the FHA –Recommended approach for developing Line of Business Target Architectures (29 Apr 2004) Legislation –2003 E-Government Act –HIPAA –Clinger Cohen Act of 1996

4. 3 Strategic Framework and FHA Visions Dr. Brailer’s Framework for Strategic Action: Consumer-centric and Information-rich Health Care FHA: Safer and healthier citizens have improved access to health related information and services.

5. 4 Strategic Framework and FHA Goals Dr. Brailer’s Framework for Strategic Action: Inform Clinical Practice Interconnect Clinicians Personalize Care Improve Population Health FHA: Improved coordination and collaboration on national Health IT Solutions Improved efficiency, standardization, reliability, and availability of comprehensive health information solutions.

6. 5 Strategic Framework Goals with Strategies Inform Clinical Practice Incentivize EHR adoption, Reduce risk of EHR investment, Promote EHR diffusion Interconnect Clinicians Foster regional collaborations, Develop a national health information network, Coordinate federal health information systems Personalize Care Encourage use of PHRs, Enhance informed consumer choice, Promote use of telehealth systems Improve Population Health Unify public health surveillance architectures, Streamline quality and health status monitoring, Accelerate research and dissemination of evidence

7. 6 FHA Principles Standards: Establish Federal interoperability standards. Investments: Coordinate Federal investments with business architecture. Data Collection: Minimize the data collection burden. Information Assurance: Secure Federal information. Functionality: Leverage standardization based on common functions. Information Access: Provide access to information. Proven Technologies: Select proven market technologies. Privacy: Comply with the Privacy Act of 1974. Evolution: Develop the architecture via a series of releases. Compliance: Comply with the law as expressed in legislative mandates, executive orders, Federal regulations, and other Federal guidelines. Representation: Collect architectural information from those who possess the knowledge of the business processes and associated information.

8. 7 Intended Uses of the FHA Provide common terminology for use within and across agency architectures Identify and evaluate opportunities for: –Business process improvement –Enhanced information sharing across agencies –Addressing key gaps in mission performance –Enhancing IT automation support –Matching existing/planned solution providers to customers –Evolving to a family of common solution “patterns” –Reducing redundant investments

9. 8 FHA Scope Business Lines and Sub-functions from the BRM Revision Consumer Health and Safety Population education Facility Registration and Certification Product Approval Health Alerts Promotion of Preventive Practices Agriculture Trade Management Ensuring a Healthy Food Chain Monitor Food and Drug Supply Investigative Operations Laboratory Operations Conduct Recalls Product Inspection Import/Export Activities Facility Inspection Conduct Compliance Create Standards & Guidance Health Advancement Diagnostics and Clinical management Quality of Care-improving Illness Prevention Conduct Health Related Research Laboratory Research Epidemiologic Methods Research Prevention Research Survey and Statistical Methods Research Health Effects Research Diagnostic Lab Testing and Quality Assurance Program Evaluations Health Training and Education Conservation of Endangered Species with Medical Properties Infrastructure Assessment and Development Conservation of Endangered Species with Medical Properties Planning and Forecasting Health Care Services Patient Education Immunization Management Managed Services Quality of Care-sustaining Emergency Response Outbreak Investigation and Intervention Technical Assistance and Consultation Program Implementation Assess Beneficiary Health Status Plan Health Services Deliver Health Services Manage Information/Manage Documentation Coordinate and Integrate Health Services Ensure Quality of Health Services Population Health Mgmt. Public Health Surveillance Health Determinants Epidemiologic Studies Vital Statistics Health Surveys Health Risk Assessment Detection Information Dissemination Prevention & Exclusion of Animal and Plant Pests and Diseases Invasive Species Management Interdiction of Smuggled or Illegal Trade/Transport Animals or Plants Define and Assess Population Develop Population Health Management Practices Implement Tools / Manage Processes Evaluate Population Health Management Access to Care Food and Nutrition Assistance Manage Enrollment and Eligibility Perform Assessment and Plan for Care Schedule Services and Check-in Manage Patient Movement and Patient Encounter Support Beneficiary Services Assess Effectiveness of Access to Care Support Community Outreach

10. 9 Adapted from the Federal Enterprise Architecture Framework, Version 1.1, September 1999 Federal Health Architecture Framework Technology Components Data Security Standards Transitional Processes Target Business Architecture Data Architecture Components Architecture Architectural Models Strategic Direction Business Drivers Design Drivers Business Architecture Data Architecture Health Care Services Consumer Health & Safety Access to Care Population Health Management Current Business Architecture Data Architecture Components Architecture Security Architecture Security Profile Health Advancement Investment Review Segment Coordination Asset Management Components Architecture Technology Architecture Technology Architecture Technology Architecture Market Research Vision Principles

11. 10 FHA Products The Direct Products of this Investment will include the following: A framework or roadmap for future health investments Long team partnerships and collaboration across the health LOB A robust FHA repository serving as a tool for decision making Identification of gaps or opportunities where there is no consensus Suggested transition strategies or plans.

12. 11 Federal Health Architecture Framework Work Products Level Management and Governance Performance Mission, Logistics, and Business Data and Information Technical Solutions Technical Standards Security and Privacy Transition Enterprise / FHA-level Policy Principles Roadmap Governance Plan Program Management Plan Communications Plan Framework Repository Federal Health Architecture Performance Plan (for each fiscal year) FHA Missions and Business Lines Enterprise Roles, Authorities, and Organizational Relationships FHA Integrated Dictionary FHA Information Objects FHA Information Sharing and Exchange Matrix FHA Systems Inventory FHA Solution Patterns Technical Reference Model FHA Standards Profile FHA Technology Forecast FHA Information Security Profile FHA Privacy Profile Strategic Assessment Report FHA Issues and Resolutions FHA Transition Plan Work Group Level Performance Plan and/or Customer Service Standard (for each mission area and also for each region) Concept of Operations (for particular functional areas) Node Connectivity Diagram Roles, Authorities, and Organizational Relationships Operational Sequence Diagram Information Sharing and Exchange Matrix (subsets of the FHA IESM associated with a particular mission or function) Systems, Components, Services, and Interfaces Systems Communications Description Mission Analysis Report (for particular mission areas)

13. 12 Data and Information Work Products