1. National Health Information Infrastructure (NHII): Moving Toward Implementation Helga E. Rippen, MD, PhD, MPH Deputy Senior Advisor National Health Information Infrastructure Department of Health and Human Services Helga E. Rippen, MD, PhD, MPH Deputy Senior Advisor National Health Information Infrastructure Department of Health and Human Services HL7 Meeting May 2004

2. 2 2 Overview I. What is NHII? II. HL7-EHR Functional Standards III. HL7-EHR Interchange Standard IV. Future – Computable Guideline Exchange Standard I. What is NHII? II. HL7-EHR Functional Standards III. HL7-EHR Interchange Standard IV. Future – Computable Guideline Exchange Standard

3. 3 3 I. What is NHII n Standards n EHR for all providers and settings n Community health information exchanges n Standards n EHR for all providers and settings n Community health information exchanges

4. 4 4 Clinical Encounter Index of where patients have records Temporary Aggregate Patient History Patient Authorized Inquiry Hospital Record Laboratory Results Specialist Record Patient data delivered to Physician LHII system Records Returned Requests for Records community

5. 5 5 Index of where patients have records Temporary Aggregate Patient History Authorized Inquiry from LHII Hospital Record Laboratory Results Specialist Record Patient data delivered to other LHII LHII system Records Returned Requests for Records U.S. another LHII

6. 6 6 HL7-EHR Functional Standards n Congratulations! n EHR interchange standard must accommodate the information needed to support the functions defined in the DSTU n Congratulations! n EHR interchange standard must accommodate the information needed to support the functions defined in the DSTU

7. 7 7 HL7-EHR Interchange Standard n Goal: l Transmission of complete EHR between any system without information loss n Requirements l Information model must accommodate all possible types of information (from scanned documents to fully standardized and encoded records) l Arbitrary subsections of the record can be transmitted l Implementation should not require bilateral technical agreements (need meta-transactions) n Goal: l Transmission of complete EHR between any system without information loss n Requirements l Information model must accommodate all possible types of information (from scanned documents to fully standardized and encoded records) l Arbitrary subsections of the record can be transmitted l Implementation should not require bilateral technical agreements (need meta-transactions)

8. 8 8 Future – Guideline Interchange Standard n Goal: l Sharing fully computable decision support algorithms n Problem: l Every site of care can not muster the resources to develop a complete suite of decision support algorithms n Solutions: l Standard for encoding decision support would allow sharing and distribution of algorithms (i.e., printing press for guidelines) n Goal: l Sharing fully computable decision support algorithms n Problem: l Every site of care can not muster the resources to develop a complete suite of decision support algorithms n Solutions: l Standard for encoding decision support would allow sharing and distribution of algorithms (i.e., printing press for guidelines)

9. 9 9 Questions? Helga E. Rippen, MD, PhD, MPH Helga.rippen@hhs.gov 202/205-8678 For more information about NHII http://aspe.hhs.gov/sp/nhii Mark Your Calendar NHII 04 Meeting July 21-23, 2004 Washington, DC