S&I+Framework+Functions

Purpose and Overview
The seamless electronic exchange of health information between different organizations and different information systems will require:
 * Identifying, harmonizing, and developing use cases and health information standards
 * Tools to support the adoption and use of health information standards
 * A process to evaluate, test, and refine the standards for data exchange
 * Certification of products that meet security and interoperability standards
 * Policies and governance structures for the NHIN
 * The technical infrastructure (directories and certificate authority) for operation of the NHIN in pilot and real-world environments

This set of functions, illustrated and described below, enable the successful launch and completion of selected initiatives across the development life cycle.



Use Case Development and Functional Requirements
The S&I Framework works closely with consumers, providers, government organizations and other stakeholders to identify real-world needs, prioritize them through a open, transparent process, and create explicit, unambiguous documentation of the use cases, functional requirements and exchange requirements for interoperability.

Harmonization of Standards and Interoperability Specifications
Harmonization integrates different views of health care information into a consistent view. This activity will include merging related concepts, adding new concepts, and mapping concepts from one view of health care information into another view. This will also identify gaps that can point the way towards development of interoperability standards as required.

Standards Development Support
In order to meet the needs of the use cases and increased use of HIT, there will be a need to modify or extend the existing standards or develop new standards. The S&I framework will work with standards development organizations and with research organizations to extend existing standards, or develop new ones as necessary.

Implementation Specifications
In order to be able to test and implement the standards in real-life settings, they must be specified to a higher degree of detail. This activity will focus on the development of interoperability specifications that are independent of specific software architecture (a platform-independent model, or PIM) as well as interoperability specifications that are specific to the Nationwide Health Information Network architecture (a platform-specific model, or PSM).

Reference Implementation
The reference implementation activity creates a fully instantiated software solution that is verified to be compliant with the standards and serves as a “reference” to other software developers of what an interoperable solution looks like. The reference implementation will be accessible as a public resource with compiled code, source code and supporting documentation.

Pilot Demonstration Projects
Although a reference implementation provides value to the community through a thorough assessment of the technology; support for established standards, and vetting within the S&I Framework, a reference implementation will need to be refined through real-world pilots and demonstrations. The S&I Framework will support efforts in the refinement of the reference implementation and interoperability specifications through a number of real world demonstration and pilots.

Testing
The S&I Framework will support the development of an integration testing “harness” that will test how a particular component satisfies conformance requirements and integrates into the reference implementation. The testing activity will validate the reference implementation for conformance to specifications and standards. The testing activities will be coordinated with NIST to provide testing tools and validate that a particular implementation conforms to a set of standards and specifications.

Tools and Standards Repository
To accelerate the development, use, maintenance and adoption of interoperability standards across the industry, and to spur innovation, the S&I Framework will develop tools to facilitate the entire S&I Initiative lifecycle and maximize re-use of concepts and components, including tools and repository for browsing, selecting, and implementing appropriate standards.

Architecture Refinement and Management
The Nationwide Health Information Network architecture is a specific network architecture that realizes health information interoperability specifications based on open standards. This activity will focus on the refinement and management of the Nationwide Health Information Network Architecture to meet emerging needs of the health care industry.

Certification
In order to qualify for Medicare and Medicaid HIT incentive payments, eligible professionals and hospitals must use electronic health records (EHRs) that are certified as meeting the Secretary’s standards for technology, including security and interoperability standards. To support the certification program, the S&I Framework will work with NIST and other stakeholders to develop a robust certification program that will include:
 * 1) Developing a process for certifying EHR technology;
 * 2) Establishing technical requirements and testing infrastructure; and
 * 3) Maintaining the master list of all Certified Electronic Health Record Technology Products and make this list available for providers and purchasers of EHR technology products to meet, in part, meaningful use requirements