2.  All lines are muted during presentation.  Lines are un-muted during Q&A ◦ If not asking question, please mute your line  *6 to mute your phone  *7 to un-mute  Questions can also be submitted via the Chat Box.

3.  Scott Gordon, PhD Director, eHealth, ASTHO  Barbara Massoudi, MPH, PhD CDC BioSense 2.0 Redesign Team  Kieran Dunne, MS CDC BioSense 2.0 Redesign Team  Mike Alletto, MS CDC BioSense 2.0 Redesign Team

4. Jurisdiction Public-Access Hospital

5. Shared Spaces BioSense 2.0 Environment Jurisdiction Public-Access Hospital

6. BioSense 2.0 http://biosenseredesign.org https://biosen.se info@biosen.se In Collaboration with

7. Agilexwww.agilex.com BioSense 2.0 NwHIN CONNECT Kieran Dunne Agilex Technologies

8. Agilexwww.agilex.com What is CONNECT CONNECT is an open source software solution that supports health information exchange – both locally and at the national level. CONNECT uses Nationwide Health Information Network standards and governance to make sure that health information exchanges are compatible with other exchanges being set up throughout the country

9. Agilexwww.agilex.com Why CONNECT? Set up a health information exchange within an organization Tie a health information exchange into a regional network of health information exchanges using Nationwide Health Information Network standards

10. Agilexwww.agilex.com How to participate Install NwHIN CONNECT at local site Exchange self-signed certificates with BioSense 2.0 Gateway Configure Gateway to communicate to BioSense 2.0 Gateway Send HL7 data via Administrative Distribution Transaction

11. Agilexwww.agilex.com BioSense 2.0 NwHIN Direct Receiver

12. Agilexwww.agilex.com What is Direct? The Direct Project specifies a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet

13. Agilexwww.agilex.com Why is there a need for Direct? Communication of health information among providers and patients still mainly relies on mail or fax Slow, inconvenient, expensive Health information and history is lost or hard to find in paper charts Current forms of electronic communication may not be secure Encryption features of off-the-shelf e-mail clients not often used in healthcare communications today Physicians need to transport and share clinical content electronically in order to satisfy Stage 1 Meaningful Use requirements. Need to meet physicians where they are now Direct will be one of the communication methods in the Nationwide Health Information Network Sources: http://www.flickr.com/photos/dougww/922328173/ http://www.flickr.com/photos/greenlagirl/154148230/sizes/o/ http://www.flickr.com/photos/kenjonbro/3418425029/sizes/m/

14. Agilexwww.agilex.com BioSense 2.0 Direct Architecture Sender HISP Security and Trust Agent Apache James Configuration Services BioSense HISP Security and Trust Agent Apache James Configuration Services SQUIRRELMAILCLIENTSQUIRRELMAILCLIENT SQUIRRELMAILCLIENTSQUIRRELMAILCLIENT SMTP port 25 IMAP 110

15. Agilexwww.agilex.com How to participate Install NwHIN Direct at local site Create Direct address at local site Generate and Exchange certificates Send HL7 data to biosenuser@nhin.biosen.se as an email attachment.biosenuser@nhin.biosen.se

16. Agilexwww.agilex.com CONNECT vs. Direct CONNECT Targeted towards Enterprise level usage Includes auditing and policy engine Complicated install Direct Targeted towards smaller usage level Small hospital, larger practice Less infrastructure Easier to install

17. Agilexwww.agilex.com More Information Direct Project http://directproject.org/home.php CONNECT http://www.connectopensource.org/ Onboarding documents Coming soon to http://www.biosenseredesign.org/www.biosenseredesign.org

18. Agilexwww.agilex.com Questions?

19. Mike Alletto 17 May 2012

22. Data Providers PHIN-MS NwHIN-Connect and Direct SFTP Mirth-to-Mirth VPN AWS Cloud BioSense 2 System hosted in the Amazon Cloud

25. * BioSense 2.0 was accredited and approved to operate on 14 Nov 11 (approved at FISMA-MODERATE) * The system went into live operations on 15 Nov 11 * The BioSense 2.0 application / environment received an Authorization to Operate (ATO) from CDC. It has been through the CDC’s Certification & Accreditation process, which meets Federal Information Security Management Act (FISMA) requirements. * CDC incorporates the use of National Institute of Standards and Technology (NIST) Special Publications (computer security guidance) in its Certification and Accreditation (C&A) processes. Some of the guidance specifically incorporated can be found in: * NIST SP 800-18: Guide for Developing Security Plans for Federal Information Systems * NIST SP 800-37: Guide for Applying the Risk Management Framework to Federal Information Systems: A Security Life Cycle Approach * NIST SP 800-53: Recommended Security Controls for Federal Information Systems and Organizations Note: The FISMA requirements and NIST guidance are publicly available. The NIST guidance is collected in the Computer Security Resource Center of the National Institute of Standards and Technology (NIST) site: http://csrc.nist.gov/publications/PubsSPs.html.http://csrc.nist.gov/publications/PubsSPs.html

27. 27 Secure Data Store Secure State and Local data storage Shared data access for approved partners Approved data for open access to public Local Access Shared Access Public Access Data Source Local Providers Regional or National Providers Public Health Community Environment User Interface Services Sample Jurisdictions Others State or Local User Authorized Collaborator General Public CDC User Database Service Collaboration Devices Transport Services Business Services RODS ESSENCE Data Transform and QA Others Data Access Services Raw Data

28. * info@biosen.se info@biosen.se * http://biosenseredesign.org http://biosenseredesign.org QUESTIONS