Thursday, August 23, 2012

Automate the BlueButton PULL Proposal

I managed to attend the second #ABBI call yesterday.  It's pretty clear that there will be at least three workgroups (and possibly a fourth) for this S&I Framework project.

1.  PUSH: Direct + CCD/CCDA
2.  PULL: They don't have an outline yet, but see below
3.  Content: Meaningful Use required content and possibly other stuff.

The "possible" fourth item deals with security/privacy.  However, on the call, it was pretty clear they were focused on the first three, while the WIKI page adds the fourth.  It's pretty clear that security/privacy is already being dealt with on many levels in S&I, and I'd hope that we simply reuse that work.

A lot of discussion was around the wording for the scope of the project, and focused on the differentiation between access to data, and control of it.  Rather than give you my rant about this, I'd rather you read this excellent post by Fred Trotter.

On PULL, what I think is needed is the following:
  1. Transport:  IHE mHealth Profile
  2. Privacy/Security:  TLS, OAuth and OpenId (see the RHEx Project)
  3. Content:  CCD [MU Stage 1] and/or CCDA [MU Stage 2]
It should be pretty easy to create a connector between an XDS registry and repository (or an XCA Gateway) to support access to content via the IHE mHealth profile.  It looks like I'm going to be creating a prototype to demonstrate that capability.  I guess I'm going to have to find some OAuth/OpenID Server side code to reuse for this.

The benefit of this approach is that the XCA Query is already included in the Exchange specifications and in CONNECT.  So, if I can adapt an IHE mHealth request into an XCA Query, this should provide a great deal of compatibility with many existing NwHIN nodes for the PULL capability.

The IHE mHealth profile DOESN'T require an underlying XDS/XCA infrastructure.  The point of developing this prototype is simply to demonstrate what the mHealth profile can do to support patient access.  I've found through the Query Health project that demonstrating is much more convincing than talking about it.

I'm planning on starting with the Open Health Tools IHE Project (ppt), and perhaps contributing the code to support the IHE mHealth profile.


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