1. Nick Vennaro, NHIN Team (Contractor), Office of the National Coordinator for Health IT Michael Torppey, CONNECT Health IT Security Specialist (Contractor) Federal Health Architecture, Office of the National Coordinator for Health IT Security and Privacy for the NHIN and CONNECT 1 WEDNESDAY, 5:00 – 5:30PM

2. Agenda Welcome Nationwide Health Information Network (NHIN) NHIN Architectural Components NHIN Network Gateway Components CONNECT Gateway Reference Implementation: FHA CONNECT Certification & Accreditation (C&A) and Security Management Program Overview C&A Procedure/Status CONNECT Security Management Program HIMSS 20102

3. Nationwide Health Information Network (NHIN) NHIN NHIN is not a database Harmonized standards to exchange health data Membership agreements SSL Certificates Services Registry Test Environment – Interop and conformance HIMSS 20103

4. NHIN Components Components NHIN Network – Zone for transporting health info between gateways – Certificates, Services Registry, agreements, Test Environment, Specifications Gateway – Systems that implement NHIN Specifications Intra-HIO Zone – Systems within the HIO Patient Facing Zone – Interface with patient. Provider system or Personal health record HIMSS 20104 Patient-facing Zone Intra-HIO Zone Trust Fabric Agreements, Policy & Governance NHIN Security HI Security Provider Security HI Security Patient-facing Zone Intra-HIO Zone NHIN Network Gateway Provider Patient PHR EHR Lab EHR Gateway Certificate Authority provides secure SSL Certificates for Gateways Provider Patient Gateway

5. NHIN Components – Architectural View HIMSS 20105

6. NHIN Security Infrastructure – Managed PKI Entrust – Certificate Authority mPKI software/service to manage SSL certificates SSL worldwide standard Certificates encryption between gateways Certificates insure HIO has been vetted by NHIN HIMSS 20106 or Server 1 2 4 3

7. NHIN Security Data Use Reciprocal Support Agreement (DURSA) Part of the chain of trust Trust agreement signed by HIO Legal framework for NHIN participation Confidentiality, performance, data use, etc HIMSS 20107

8. NHIN Security – HIO Security Guidelines Non-binding best practice security guidelines for HIO Foundational security elements to a secure system – Network security – Firewalls – Message security – Where to get more info HIMSS 20108

9. NHIN Network Gateway Component Services Registry - UDDI Universal Description Discovery and Integration Service listings and associated meta data Hosted Systinet Solution Maintained by NHIN Production and test platform HIMSS 20109

10. NHIN Network Gateway Component Test Environment Interoperability Testing – can the HIO successfully participate in a data exchange Conformance Testing – does the HIO conform to the specifications Methods, process, procedures, and environment to test gateway software HIMSS 201010 (Internet employing CA/UDDI) NHIN Interoperability Testing Lab NIST Conformance Tools 12 Candidate System

11. CONNECT Reference System (CRS) Certification & Accreditation (C&A) and Security Management Overview 11

12. CONNECT C&A - Procedure A thorough understanding of the risk that the system presents to the business\technical operations of federal partners and public & private organizations A full set of C&A documentation (system security plan, security artifacts, reports, data, etc.) A Security Test and Evaluation (ST&E) was conducted to verify that all controls are implemented and performing as described Identification, categorization and prioritization of action items (POAMs) to address and monitor “weaknesses” An Authorization to Operate (ATO) from the HHS Designated Approval Authority (DAA) Continuous Monitoring - combines input from C&A with planned lifecycle development & systems operations processes to maintain security posture 12 HIMSS 2010

13. CONNECT C&A - Status CRS ver. 2.1 C&A package completed, delivered and reviewed by the HHS Certifying Authority, Dan Galik (HHS CISO) on 1/15/2010 Approved on 1/22/2010 by the HHS Designated Approval Authority (DAA), Michael Carleton (HHS CIO) with an Authorization to Operate (ATO) granted CRS ver. 2.2 has been through a “Change Risk Assessment” which was reviewed and approved by the CRS Business Owner and Information System Security Officer (ISSO) CRS ver. 2.3 re-assessment is in process Future releases of CRS will be re-assessed in accordance with the CRS Continuous Monitoring Plan 13 HIMSS 2010

14. CONNECT Security Management Program Continuous Risk Management Risk Assessment and Security Planning Policies & Procedures Risk Analysis as part of the development cycle Periodic Risk Assessments Risk Mitigation Vulnerability scanning Patching Incident response coordination Feedback loop with installed base Security Controls and Continuous Monitoring FISMA controls cover a wide breadth of technical, management and operational safeguards ST&E, POAMs and Re-Assessments C&A and the Non-Federal Community 14 HIMSS 2010

15. CONNECT C&A: Extended Impact Operational Security Impact – Security Program A one-time, narrowly enforced C&A effort misses overlap opportunities with security program management and risk management requirements Opening up C&A by including continuous monitoring blends the complementary security goals of compliance and ongoing operational security Doing so will also leverage the spending and resource time spent on compliance into effective and efficient ongoing security practices HIMSS 2010 15 C&A Process – System Information Revealed information types contained relative importance of the system to the organization security controls that protect the system system risks system boundaries Operational Security Impact: Configuration baselines Implementation guidelines “Defensive” mechanisms (IDS, firewall rule sets, etc.) Repeated

16. CONNECT C&A – Extended Impact Operational Security Impact – Monitoring HIMSS 2010 16 C&A – Continuous Monitoring Strategy Continuous Monitoring Methods Automated processes IT management systems C&A re-assessment Periodic audits Select controls & monitoring approach System baseline categorization Control effectiveness Impact of system or environment change Operational Security Impact: Vulnerability discovery and mitigation Continual update of SSP and ST&E documents More efficient risk analysis and resource planning

17. Thank You 17 The participation of any company or organization in the NHIN and CONNECT area within the HIMSS Interoperability showcase does not represent an endorsement by the Office of the National Coordinator for Health Information Technology, the Federal Health Architecture or the Department of Health and Human Services.