About+RHEx

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NwHIN Power Team Recommendations
The NwHIN Power Team was tasked to assist the ONC in “…evaluating the specifications developed for the Exchange and Direct pilots with respect to their usability and scalability to support nationwide health information exchange [and] recommending those specifications that could be integrated and deployed to support the secure transport and exchange of electronic health information at a national scale, and identifying where further work may be needed.[1]”

In their recommendations to the HITSC, the NwHIN Power Team identified REST as a widely accepted complementary technology to several important health information exchange specifications, and stating:

"… Developing specification(s) for ‘secure RESTful transport for healthcare exchange’ would provide healthcare organizations assurance that RESTful implementations built in accordance with the specification(s) would be predicable and secured.[2]"

Stage 2 Meaningful Use NPRM and REST
In a recent Notice for Proposed Rule Making (NPRM) issued on March 7, 2012, ONC evaluated each of the 2011 certification criterion along with the recommendations from the HIT Standards Committee. In the context of existing accepted protocols of SOAP and SMTP, the NPRM states:

While we would only permit EHR technology to be certified to these two transport standards [SOAP and SMTP], we intend to monitor innovation around transport and would consider including additional transport standards, such as a RESTful implementation, in this certification criterion. The inclusion of additional standards in this certification criterion would permit EHR technology to be certified to added transport standard(s) and could ultimately enable EPs, EHs, and CAHs to meet MU using EHR technology certified with the added transport standard(s).[3] =A RESTful Prototype: RHEx=

RHEx Execution
In order to demonstrate easier, secure health information exchange via RESTful design, FHA initiated the RHEx project. The RHEx project is:
 * Piloting the application of proven standards and protocols to explore a RESTful approach to exchanging health information; and
 * Requesting community involvement through this wiki and other vehicles to refine and evolve the RHEx reference implementation and profile.

Phased Approach to RHEx Development:
RHEx is being developed in two phases. In the first phase, the focus is about securing RESTful interactions. This will ensure necessary standards are in place to demonstrate the secure exchange of information via the web using hypertext transfer protocol (HTTP). Once the RHEx project establishes consensus around satisfactory and complete RESTful security, the second phase of the project will expand to show the full benefit of a RESTful interface and incorporate the content layer. Thus, the two phases of development and delivery are: =RHEx Stakeholders= RHEx is sponsored by the Federal Health Architecture (FHA) program.
 * **Phase I:** Security approach for a RESTful health information exchange (April-June 2012); and
 * **Phase II:** Content approach for a RESTful health information exchange (July-September 2012)

The Federal Health Architecture (FHA)
The Federal Health Architecture (FHA) is an E-Government Line of Business initiative managed by the Office of the National Coordinator for Health IT [4]. FHA was formed to coordinate health IT activities among the more than 20 federal agencies that provide health and healthcare services to citizens.

FHA and its federal partners are helping build a federal health information technology environment that is interoperable with private sector systems and supports the President’s plan to enable better point-of-service care, increased efficiency and improved overall health in the U.S. population.

The Office of the National Coordinator for Health Information Technology (ONC)
ONC is at the forefront of the administration’s health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care[5]. ONC is organizationally located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS).

ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. The position of National Coordinator was created in 2004, through an Executive Order, and legislatively mandated in the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009.

Health IT Standards Committee (a Federal Advisory Committee)
The Health IT Standards Committee (HITSC) is charged with making recommendations to the National Coordinator for Health IT on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information[6].

NwHIN Power Team
Operating as a workgroup under the HITSC, the Nationwide Health Information Network (NwHIN) Power Team provides guidance and feedback to ONC for the development of objective criteria for evaluating the readiness of specifications for adoption as national standards [7].

[1] “HIT Standards Committee NwHIN Power Team Final Recommendations”, September 28, 2011: [] page 3. Accessed May 16, 2012. [2] Ibid., page 24. [3] “Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology” NPRM, March 7, 2012: [] pages 17-18. Accessed May 16, 2012. [4] Website: []. Accessed May 30, 2012. [5] Website: []. Accessed May 16, 2012. [6] Ibid. [7] Ibid.

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