1. Anita Griner, Senior Project and Program Manager Centers for Medicare & Medicaid Services Nitin Jain, C-HIEP Executive Consultant (Contractor) Centers for Medicare & Medicaid Services CMS’ C-HIEP Proof-of Concept CMS Implementation of NHIN CONNECT 1 TUESDAY, 4:30 – 5:30PM

2. Session Objectives 1 C-HIEP Overview 1 Technical Components 2 NHIN Integration into CMS 3 Challenges, Lessons Learned and Next Steps 4 HIMSS 20102

3. What is C-HIEP? 17 Proof-of-concept Align with national standards for data interoperability Move towards a uniform, harmonized data set Move towards enhancing the ability for communication and coordination of care across settings Continuity Assessment Record & Evaluation CARE Health Information Exchange Project HIEP HIMSS 20103

4. C-HIEP Participants HIMSS 20104 20 CMS: Project Owners Contractor: Technical HIOs: Participants

5. C-HIEP CONOPS Provider Settings: 1.Nursing Facilities (including skilled) 2.Home Health Agencies 3.Inpatient Rehab Centers 4.Long Term Care Hospitals 5.Acute Hospitals 6.Physicians Offices 7.Outpatient settings Provider Settings: 1.Nursing Facilities (including skilled) 2.Home Health Agencies 3.Inpatient Rehab Centers 4.Long Term Care Hospitals 5.Acute Hospitals 6.Physicians Offices 7.Outpatient settings HIMSS 20105 HIO CMS

6. Technical Details Data Interoperability: HITSP C83 Content Specification http://hitsp.org/ConstructSet_Details.aspx?&PrefixAlpha=4&PrefixNumeric=83 http://hitsp.org/ConstructSet_Details.aspx?&PrefixAlpha=4&PrefixNumeric=83 Exchange Interoperability: NHIN Specification: Document Submission Service Interface Specification (new “push” model) Based on: IHE CROSS-ENTERPRISE DOCUMENT RELIABLE MESSAGING (XDR) NHIN messaging platform and authorization framework components: Including: SOAP messaging, SAML Assertion, 2-way SSL HIMSS 20106

7. C-HIEP Information Flow HIMSS 20107 HIO Physician Encounter Summary Validate Assessment Data Discharge Summary CHIEP Database Acknowledgement Latent Response Document Submission Authorize User Validate Message Security CHIEP Assessment Data Analytics Analytics Reporting & Dashboards De-Identify CHIEP Assessments Create C-HIEP Assessment Documents Check Duplicate Check De-identification Check Patient Eligibility Validate Metadata Validate Document Validate Store Native Doc Transform Doc Store Data Objects Persist Build Accept/Reject Response Return Response Reply Long Term Care Hospital Acknowledgement

8. C-HIEP 3 Zone Architecture HIMSS 20108

9. C-HIEP Challenges to Date Participants Differences in technical maturity, business models capabilities, and data availability/interoperability Specifications No “Push” NHIN Spec Available (i.e. Query and Retrieve, HIEM) No existing HITSP specification aligned to CARE/C-HIEP data set Policy Privacy: Requirement to de-identify C-HIEP data challenging for case-threading NHIN DURSA Technical Larger data volumes available than anticipated Maturity of NHIN & compatibility within CMS HIMSS 20109

10. Next Steps Continue technical development and testing of C-HIEP components Production data submission from HIOs to begin summer ‘10 Continued work on data set and standards for interoperability Gathering of lessons learned and re-aligned objectives for future phases of the CARE data set HIMSS 201010

11. Thank You 11 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.