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EHR|HIE Interoperability Workgroup (IWG) and Exchange Testing Task Group

|
August

22
, 2012

Page
1

EHR / HIE Interoperability Work Group

| NwHIN Exchange

Testing
Spec and Test Scenarios Task Group

Meeting Notes

August

22
,

2012


Group Chair(s):

John

Donnelly
, New Jersey

Eric Heflin,
Texas/NwHIN Exchange


Support Staff:

Cayla Lopez
, VTM

Attendees
:

Dennis Wilson, CCHIT


Jennifer Puyenbroek,
Connect PTO


Vladi Reznikov, Connect PTO

Kyle Meadors, Drummond Group

Tim

Dunnington, ICA


Kevin Brown, ICSA Labs

Michelle Knighton
, ICSA Labs

Amit Trivedi, ICSA

Labs


Brent Bonnington, IHIE

Melissa Owens, Marshfield Clinic

Steve

Leighty
, MedVirginia


Ivan Handler, OHIT

Tom Wilson, OptumInsight

Kevin Brady, NIST

Joe
Lamy, Nitor (
ONC
Test Team)

Judith Hutman
,

Nitor

(ONC Test Team)


David De Groot, Nitor

(ONC Test Team)

Nick VanDuyne, New York

David Tao, Siemens

Marty
Prawl,
SSA

Traci Mapps
, SLI Global

Curtus Browning,
V
H
A


Dennis Peterson, V
H
A



Michael Hunter, 5am Solutions (ONC Test Team)

James Rachlin, 5am Solutions (ONC Test Team)


Agenda:



Roll Call


Cayla



Announcements


Eric



Direct harmonization


Judith



Test execution status


Judith



soapUI demo


Judith



Open Discussion


All



Wrap Up/Schedule Review
-

Eric


Meeting Documents:



Joint
-
I
WG
-
Exchange
-
Test
-
Workgroup
-
2012
-
08
-
22
-
v003a


Meeting Notes:

The meeting began at
3
:0
3
p
m

E
D
T
.


Announcements



E. Heflin
noted the h
armonized PD/QD/RD/MP/A
F t
ests
had been ratified last week. It was noted
f
uture changes
were

possible, but
would

be incorporated into the next phase of test cases design
and
implementation. The harmonized test artifacts can be located at the following link:
http://
excha
nge
-
iwg.wikispaces.com/Test+Artifacts+Harmonization



E. Heflin noted the eHealth Exchange Testing Pilot information session was scheduled for this week
to begin work on the test cases and verify that they function as
expected

and were
prioritized

EHR|HIE Interoperability Workgroup (IWG) and Exchange Testing Task Group

|
August

22
, 2012

Page
2

accordingly. It was noted
participants

will

be asked

to pull down

soupUI scripts,
and/or
supporting
documents and test cases to conduct self
-
testing.



E. Heflin discussed the
RFP

process and noted the evaluations were still underway.


Harmonization Phase
s



E. Heflin provided a brief recap of the harmonization phases for the Unified Test Process. It was
noted Phase 1


SOAP
Query/Retrieve
; Phase 2


Direct Send/Receive; and Phase 3


Secondary
Methods, Service Discovery & Provider Directories had been revie
wed by the group last week and
there were
no
major objections to adopting this
harmonized

3
-
phase

approach.


Direct H
armonization



J. Lamy presented on the direct harmonization process and provided an analysis of the
tested

artifacts

and deployment models.



It was noted in the analysis of the test artifacts the test team was in the process of breaking down
the
EHR
-
HIE
test specifications

into modular components

and mapping them to the ONC test cases.



J. Lamy
discussed
the test approa
ch and provided use cases for the direct only vs. internal actors
with regard to an email client with a full service HISP, internal actor testing, and various deployment
models.




J. Lamy noted t
he ONC test packages verify
the
f
unctionality through
infere
nce

and that e
very grey
box

in the provided illustrations
represented

functionalities between the sender and receiver. It was
noted
the

use cases do
not call out internal messaging

between components not involving the HISP
sender/receiver component
.



E. Hef
lin

inquired if
the
term
“security trust a
gent


was considered an overloaded term for
verifying
the role of the certificate.




It was noted
HISP functionality
was
sometimes bundled into

an

EHR

thus the test cases should not
assume or require a HISP
-
only approach vs. a HISP as part of another system approach.

J Donnelly
noted
that HISP functions and actors would be appropriately identified

in the test packages so

to
support any of the deployment

models.



It was noted the r
eferenced language
may imply that there was a favored deployment model for
HISP
. It was noted
there was a need to have an institutional backing that will support trust and
certify the relationships. J. Lamy noted the term HISP w
as typically used to represent automated
functionality that acts on trusted relationships.



There was discussion whether or not a
full service HISP
would
also include
a provider directory.



B. Bonnington noted there
was no requirement

for a provider director
y with some HISP and that
if
the

term “full
-
service HISP”

is utilized, it

should be
clearly

defined as it may have several different
interpretations.




J. Lamy reviewed the various deployment models outlined in the slide and discussed trust
verification.



Deployment Model E.1



The group

reviewed Deployment Model E.1 with the
direct

project sending XDR with a Trusted
Service Provider. It was noted from HISP to HISP it was specific to SMTP + S/MIME. J.
Lamy

noted
there was no requirement that
the
object

in the green cloud (endpoint in XDR exchange) and the
items in the box
es

have to belong to the same organization.



There was d
iscussion of
the
various deployments
and the

various actors under test.
It was noted
SMTP could be
considered a

test tool.



I. Handler
inquired

what the purpose was of the XDR,

if the

direct protocol encrypts
everything
including metadata.

E. Heflin
noted

the

ultimate
receiver of XDR
was an
entity
that would decrypt
EHR|HIE Interoperability Workgroup (IWG) and Exchange Testing Task Group

|
August

22
, 2012

Page
3

payload and the receiver would

use
the
metadata associated wit
h payload
to assist with internal
distribution of the payload and
for the

doc
ument

repository.



I. Handler noted there were
limitations
from an

operational point of view
regarding

the need
to
have different end
-
points

liste
d for different
transmissions
.




It was noted
FR4 and FR6
did

not correlate to something within the ONC
,

as it was

primarily

XD to
XD.

It was noted

FR9 corresponds to family of ONC test cases
.


Deployment Model E.2



The group reviewed the deployment model E.2 for a direct project received

from XDR with Trusted
Servi
ce Provider.



It was noted the XDR link was considered secure in certain ways but included abstract measures.



E. Heflin

noted
the XDR
profile from IHE can be secured using multiple techniques, such as VPN or
WSS, and it can be s
ecured via deployment inside a secure datacenter.



Other Deployment Models: Unclear Testing Path



The group discussed the Deployment Model C for a

web
-
based portal
. It was noted the I
WG had

focus
ed

on end
-
to
-
end

solutions

and there was discussion as to
whether scope should include
something broader

or narrower
.



I. Handler noted
ev
erything before or after HISP was

irrelevant unless satisfied

by

HISP exchange.



J. Lamy confirmed the ONC was
agonistic

to where the HISP lived and that the goal was to
ca
pture

the encrypted message
.



D. Tao
noted

in the second box
for deployment model C the HISP builds

XDM and inquired if this
was

a
web
-
p
ortal hanging off a HISP or HIE.

J
.
L
amy noted this was

one option for building an XDM
and that the

ONC
differentiates

between

an actor that sends
a
mail message and
an
XDM
that
zip
s

files

and creates metadata for those files
.


Sample Analysis: Edge Protocol EHR/HIE Test Specification FR
-
2



The group r
eviewed FR
-
2
: Applying a Modular Approach.



E.
Heflin noted

that
if
the group
opted

to levy additional requirements
, such as for content,

it
would
use
a
modular approach

for existing test artifacts.



It was noted XD conversion was

an

optional feature to implement
.



It was noted from a work
-
flow perspective there were requirements on

how data would be
structured and E. Heflin confirmed this was dependent on the specification content standard. It was
noted the direct specification was content agnostic.



Round
-
the
-
Room



It was requested that the participants on the call provide their feedback as to whether or not they
should levy normative conditional requirements for specified deployment models/edge protocols
and if so, how far they should go in accommodating other (unkn
own) deployment models.



C. Lopez began a round
-
the
-
room to request feedback. The initial feedback received was that the
current requirements for the specified deployment models were sufficient and overtime additional
models may be identified.



It was not
ed due to time limitations, additional feedback should be communicated over email.


A
djournment

The m
eeting adjourned at 3:55
pm E
DT.