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Tuesday, May 15, 2012

Reading the NwHIN RFI

If you're based in the US like me, and you are reading this blog, you are likely to be reading the NwHIN RFI when it comes out (real soon now) from the Federal Register.  If you aren't, consider yourself fortunate.  We just put one set of regulations to bed (for commenting anyway) just a few days ago, just in time to start reading more.

This one is a tough read to start with, because you have to decode a lot of new acronyms and noun-phrases that appear to have shown up out of thin air.  My first principle of governance is that existing terms already in the lexicon of your readers must be used before inventing new stuff, and all new stuff must be approved by Noah Webster (which he won't do for reasons that should be obvious).

Here's a quick crib sheet:

Facilitators of electronic exchange
It is what it says it is, but there are a list of examples that would help illustrate what these are.  They could include any of the following terms: Direct Health Information Service Provider (HISP), Health Information Directory Provider (HIDP), Health Information Exchange (HIE), Health Information Organizations (HIO),  Health Information Handler, Clearing House.

I include HIE and HIO in the above because it doesn't matter to me which TLA you use for the verb or the noun.  If you recognize either as an organization that you belong to, are part of, do business with, or provide services to, you've recognized a possible facilitator of electronic exchange in the NwHIN.

So, what is NwHIN?  It isn't clear what NwHIN is and isn't right now, or in the future.  This definition of the NwHIN seems to say you are in the NwHIN if you use the specifications that ONC has adopted for the NwHIN, which is not quite circular.  This page presents a pretty good picture of what NwHIN Exchange (one part of NwHIN) looks like right now, but there are other parts.

Conditions for Trusted Exchange (CTE)
They define it once, but you need to decode it even there.  A CTE is a (set of) standards, specifications, implementation guides, profiles, services or policies that describe what is necessary to ensure that information exchange occurs and can be trusted.

Voluntary Framework for Facilitators of Electronic Exchange to be validated to Conditions for Trusted Exchange
A way to certify that organizations that exchange information conform to particular criteria.

Having shown, demonstrated or proven conformance to some criteria.

Network Validated Entity
An organization (subject to NwHIN governance) that has been certified against some criteria

The rules or processes by which a thing is accomplished.

Accountability Agents
Organizations which certify or accredit other organizations to ensure that they follow standards.

Updated 5/16/2012
Rich Kernan pointed me to this slide deck which will also be useful to folks:


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