TUESDAY, 4:30 – 5:30PM
CMS’ C-HIEP Proof-of Concept
CMS Implementation of NHIN CONNECT
Anita Griner, Senior Project and Program Manager
Centers for Medicare & Medicaid Services
Nitin Jain, C-HIEP Executive Consultant (Contractor)
Centers for Medicare & Medicaid Services
1
Session Objectives
HIMSS 2010
1
2
C-HIEP Overview
3
NHIN Integration into CMS
4
Challenges, Lessons Learned
and Next Steps
Technical Components
2
1
What is C-HIEP?
• 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
HIMSS 2010
Continuity
Assessment
Record &
Evaluation
Health
Information
Exchange
Project
CARE
HIEP
3
17
C-HIEP Participants
CMS: Project Owners
Contractor: Technical
HIOs: Participants
HIMSS 2010
4
20
C-HIEP CONOPS
HIO
HIO
Provider Settings:
HIO
CMS
1.
Nursing Facilities (including skilled)
2.
Home Health Agencies
1.
Nursing Facilities (including skilled)
3.
Inpatient Rehab Centers
2.
Home Health Agencies
4.
Long Term Care Hospitals
3.
Inpatient Rehab Centers
5.
Acute Hospitals
4.
Long Term Care Hospitals
6.
Physicians Offices
5.
Acute Hospitals
7.
Outpatient settings
6.
Physicians Offices
7.
Outpatient settings
HIMSS 2010
Provider Settings:
5
Technical Details
Data Interoperability:
• HITSP C83 Content
Specificationhttp://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 2010
6
C-HIEP Information Flow
Physician
Long Term Care Hospital
Encounter
Summary
Discharge
Summary
Security Authorize User
Validate Message
HIO
Validate
Assessment
Data
Create C-HIEP
Assessment
Documents
De-Identify
CHIEP
Assessments
Analytics
Reporting &
Dashboards
Document
Submission
Acknowledgement
Latent
Response
Acknowledgement
Check Duplicate
Check De-identification
Validate Check Patient Eligibility
Validate Metadata
Validate Document
CHIEP
Assessment
Data Analytics
Store Native Doc
Persist Transform Doc
Store Data Objects
CHIEP
Database
Build Accept/Reject
Reply Response
Return Response
HIMSS 2010
7
C-HIEP 3 Zone Architecture
HTTPS/POST
HTTPS/POST
XML Gateway
Solaris
WAS
Solaris
Outbound
Response
Handling
R
MQ
Linux
MQ
L
WBI
Data
Transformation
CHIEP Receipt Application
(CRA)
R
Audit &
Logging
Service
Data
Storage
L
L
R
Document
Submission Adapter
Linux
MQ
R
L
Policy
Engine
Adapter
Data
Validation
& Business
Rules
MQ
CMS CONNECT Adapter
CRUD (JDBC)
CMS NHIN
CONNECT
Gateway
Audit/
Logging
Adapter
Messaging API
Glass Fish
Inbound
Request
Handling
Direct Submitting
Provider
Solaris
Glass Fish
Configuration Module
NHIN / INTERNET
HTTP Server
Application
Zone
Data
Zone
C-HIEP
Database
(ORACLE)
Presentation
Zone
XML
Document
Repository
Audit Data
HIMSS 2010
Metadata
Registry
Care-Set
Relational Data
8
C-HIEP Challenges to Date
Participants
Policy
• Differences in technical maturity,
business models capabilities, and
data availability/interoperability
• Privacy: Requirement to
de-identify C-HIEP data
challenging for case-threading
• NHIN DURSA
HIMSS 2010
Specifications
Technical
• No “Push” NHIN Spec Available
(i.e. Query and Retrieve, HIEM)
• Larger data volumes available than
anticipated
• No existing HITSP specification
aligned to CARE/C-HIEP data set
• Maturity of NHIN & compatibility
within CMS
9
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 2010
10
Thank You
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.
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