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HIT Standards Committee. DRAFT: S&I Framework Principles and Processes. S&I Framework. KICK-OFF. S&I Mission. Promote a sustainable ecosystem that drives increasing interoperability and standards adoption

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Hit standards committee

HIT Standards Committee


S&I Framework Principles and Processes

Kick off

S&I Framework


S i mission
S&I Mission

Promote a sustainable ecosystem that drives increasing interoperability and standards adoption

Create a collaborative, coordinated, incremental standards process that is led by the industry in solving real world problems

Leverage “government as a platform” – provide tools, coordination, and harmonization that will support interested parties as they develop solutions to interoperability and standards adoption.

Onc standards and interoperability framework
ONC Standards and Interoperability Framework

Pilot Demonstration Projects

(Lockheed Martin)

Standards Development


Reference Implementation

(Lockheed Martin)

Harmonization ofCore Concepts


Implementation Specifications


Certificationand Testing


Use Case Developmentand Functional Requirements


Tools and Services(Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository, Testing Scripts, etc)


Standards and interoperability organizational structure
Standards and Interoperability Organizational Structure

Standards and Interoperability


National Health Information Network

Certification and Testing


Standards Teams

NHIN Teams

Certification Team

FHA Teams




Use Cases




Reference Implementations

(Lockheed Martin)

Standards Development


Test Infrastructure


Emergent Pilots

(Lockheed Martin)





Spec Factory




What is an iepd
What is an IEPD?

  • An Information Exchange Package Documentation (IEPD) is a collection of artifacts that describe the construction and content of an information exchange

    • Developed to provide the business, functional, and technical details of the information exchange through predefined artifacts

    • Created with a core set of artifacts in a prescribed format and organizational structure to allow for consistency

    • Designed to be shared and reused in the development of new information exchanges through publication in IEPD repositories

    • IEPDs contain design specifications for an information exchange but may not include supplementary information such as implementation decisions.

The iepd artifacts
The IEPD Artifacts

IEPDs contain both required and recommended artifacts

Required : Bold

Recommended : Italic

Note: Best practices for most organizations include many of the optional artifacts listed here

Scenario Planning

  • Business Process

  • Use Cases

  • Sequence Diagrams

Analyze Requirements

  • Business Rules

  • Business Requirements

Map & Model

  • Exchange Content Model

  • Mapping Document

Build & Validate

  • Subset Schema

  • Exchange Schema

  • XML Wantlist

  • Constraint Schema

  • Extension Schema

  • Main Document

  • IEPD Catalog

  • IEPD Metadata

  • Sample XML Instances

  • XML Stylesheets

Assemble & Document

No required artifacts. Publish the IEPD to a repository and implement the exchange

Publish & Implement

S i niem harmonization strategy
S&I NIEM Harmonization Strategy

Human Services

Human Services

ONC’s Office of Interoperability and Standards is building a Health Information Exchange Model (NIEM Health) that is harmonized with NIEM

Health and Human Services petal to serve as bridge between NIEM and NIEM Health

S i niem process harmonized
S&I NIEM Process Harmonized

S&I Development Phases


Release &







Assemble & Document

Map & Model

Pub. & Impl.

Scenario Planning

Analyze Requirements

Build & Validate

NIEM Lifecycle

Use Case Development


Spec Development

Reference Impl

Cert &Testing

Health Community

S&I Governance

Requirements for a model centric approach
Requirements for a Model Centric Approach Model

  • The modeling approach used by the S&I Framework must

    • Provide traceability from Use Case and Requirements through to one or more implementations

    • Provide semantic and syntactic modeling constructs to support defining the information and behavior that are part of exchanges

    • Support the need to harmonize with existing standards defined at different levels of abstraction

    • Be adoptable by different organizations

    • Be able to integrate into NIEM process

Model centric solution mda
Model-Centric Solution - MDA Model

  • Base S&I Framework modeling on the 3 OMG/MDA model abstractions.

    • Computational Independent Model (CIM)

    • Platform Independent Model (PIM)

    • Platform Specific Model (PSM)

  • Define a mechanism to show traceability from Use Cases and Functional Requirements through to technical bindings defined in a PSM.

  • Define a flexible modeling foundation by which different types of specifications can be defined.

  • Provides ability for multiple technology bindings for the same set of logical specifications (multiple PSMs)

Model centric solution niem

Behavior Model Model

Domain Model

Web Services Schema and WSDL

Use Case Model, Interaction Model, Domain Model

Vision Document, Process Model

Main Document, IEPD Catalog, IEPD Metadata, Sample XML

Exchange Schema, Subset/Constraint Schema,

Business Processes, Use Cases

Business Rules, Business Requirements

Exchange Content Model, Mapping Document

Model Centric Solution - NIEM

S&I Activities

NIEM Processes and Artifacts

Specification Models

Scenario Planning

Use Case Developmentand Functional Requirements


Harmonization ofCore Concepts

Analyze Requirements

Map and Model

Implementation Specifications


Build and Validate

Reference Implementation and Pilots


Assemble and Document

Certification and Testing

Publish and Implement

Prioritization and backlog lists
Prioritization and Backlog Lists Model



Operational Priorities

“Day to Day” Priorities within each functional team

What s next
What’s Next Model

Pilot Demonstration Projects

Standards Development

Reference Implementation

Harmonization ofCore Concepts (NIEM framework)

Implementation Specifications

Certificationand Testing

Use Case Developmentand Functional Requirements



Map &


Analyze Requirements

Build &


Assemble &


Publish &


NIEM IEPD Lifecycle

Create a NIEM Health standards harmonization process and governance framework

Establish roadmap for existing NHIN standards, MU harmonization, and non-MU health information exchange specifications

Establishes a repeatable, iterative process for developing widely reusable, computable implementation specifications

Establishing the tooling and repositories needed

Establishing the practices and guidelines for modeling

Enables semantic traceability so that useable code can be traced back to original requirements and definitions

Promotes transparency and collaboration from broad range of health stakeholders

Current lessons

S&I Framework Model


Lessons learned nhin direct
Lessons Learned: NHIN Direct Model

  • Consensus Driven Process

  • Open Collaboration

  • Established core guiding principles

  • Driven by business needs and elaborated use cases

  • Real world pilot implementation

  • Establish executive sponsorship and workgroup leads



Commandand Control


A Thousand Flowers Bloom








Lessons learned eligibility and enrollment
Lessons Learned: Eligibility and Enrollment Model

  • Dedicated resource(s) to drive project and decision making

  • Clearly defined problem statement at project initiation

  • Define expectations for desired artifacts

  • Promote community enthusiasm

  • Leverage tools to increase efficiencies



Commandand Control


A Thousand Flowers Bloom








Issues to discuss

S&I Framework Model


Issues and challenges 1
Issues and Challenges (1) Model

  • Issues and Challenges

  • How and when do we get input from other stakeholders including those outside of meaningful use?

    • VLER

    • Federal partners

    • Other stakeholders

  • How do we foster multiple working groups and create a unified view of priorities?




Priority Setting

Evaluating Artifacts

S&I Framework

Sustainable Operations

Shared Infrastructure

S i framework challenges 2
S&I Framework Challenges (2) Model

How do we create simple, easy to implement specifications that will drive adoption?

  • How do we facilitate access to SDO standards for providers and support sustainable business models?

    • Engaging the SDO community

    • Developing a “one stop shop” for implementation specifications

  • How do we foster community and industrial participation to support balanced representation and diverse priorities?

    • Identifying champions for S&I lifecycle initiatives

    • Engage communities throughout S&I Framework

    • Identifying demonstrable pilot programs

    • Engaging and incentivizing volunteers from existing community

S i framework open questions cont
S&I Framework Open Questions cont. Model

  • What are the appropriate interface points with HITSC through S&I Framework lifecycle?

    • Establish priorities, approve implementation specifications,

    • Identifying appropriate decision makers at S&I control points

    • Identifying appropriate roles and participants in the governance of S&I Framework

  • How do we identify and select tools as shared resources that foster collaboration?

    • Establishing and adhering to agreed upon modeling conventions

    • Tools to support artifact lifecycle management and dissemination

    • How do we extend NIEM to accommodate needs of health care domain?

S i framework priorities
S&I Framework Priorities Model

Prioritization needs to accommodate broad stakeholder needs, account for breadth and depth of available expertise, and support a long term growth strategy

  • What should our priorities be for the next six months, twelve months, twenty-four months? From among…

    • Meaningful Use Stage 1

    • Meaningful Use Stage 2 & 3

    • NHIN Exchange

    • NHIN Direct

    • Health Care Reform

    • VLER

    • New use cases (lab, pharmacy, content specifications)