FAST SME Panel Sessions Goals :
Reach consensus on the need for and approach of the proposed solution (Using Endpoint Discovery as an example i.e., Do we agree that single source should be federated?)
Identify alternative approaches that should be considered based on existing practice/experience (Using Endpoint Discovery as an example e.g., reach consensus that there should be a single source of API endpoint information for providers and payers or identify competing models to entertain)
Once consensus is reached:
Identify potential challenges/barriers to implement the proposed solution
Identify additional requirements that may be needed to implement the proposed solution approach
Reach consensus on proposed industry path forward, and identify potential ‘owners’ who could execute upon the proposed solution (i.e., Is CMS the right path forward/right ‘home’ for this solution? Are there other homes/owners/constituents that could execute this?)
Identify next steps to move this effort forward (i.e., Develop RFI or RFP, who issues it?)
SME’s who choose to participate in the FAST SME Sessions will have the opportunity to get an early look at the proposed solution(s) for their respective focus area and help shape the final output which will have an impact industry-wide.
Want to learn more about FAST ?
A few highlights regarding the FAST model, process, and accomplishments are included below. However, for the full summary of the FAST approach and progress, please read the 2019 End-of-Year Report.
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Image RemovedONC FAST Organization and Structure
FAST Organization & Structure
With ONC serving as the convener, the FAST collaborative adopted a taskforce model to leverage the knowledge and expertise of various SMEs across the healthcare continuum. The seven Tiger Teams aim to develop proposed approaches to address the barriers to FHIR-based solutions scalability, through additional standards work, processes, or proposed regulatory measures.
Two FAST Chief Architects ensure the taskforce is focused on the industry’s most relevant infrastructural challenges and solutions.
The FAST Coordinating Committee and the Executive Steering Committee are comprised of a public-private mix of significant, top industry leaders that review and further guide the taskforce work.
A large technical learning community (TLC) provided feedback and validation as part of the solution development process.
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FAST Work & Process
- 15 ecosystem use cases, developed by the FAST Ecosystem Use Cases Tiger Team, reflect the the infrastructural needs for the industry functional use cases to scale and ensure an efficient and scalable model to support data exchange and accelerated FHIR adoption.
- A gap analysis identified 35 technical and regulatory barriers that need to be overcome, and 15 core capabilities required to develop scalable FHIR solutions.
- 11 proposed solutions were developed across five Tiger Teams: Directory, Versions and Scale; Identity; Security; Exchange Process; Testing & Certification
- Over 1900+ people attended six interactive TLC webinars and various industry meetings and provided relevant feedback which helped refine the proposed solutions to their current status.
We look forward to collecting your feedback via the upcoming FAST SME Panel and include it in our final taskforce deliverable which will support the scalability of the industry FHIR based solutions
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FAST Proposed Solutions
The proposed solutions depicted in the diagram have been developed by each of the respective Tiger Teams.
These proposed solutions were already presented to the FAST Technical Learning Community for feedback which has been incorporated as appropriate in the current version the our proposed solutions.
The next step is where you come in. We are convening SME Panel Sessions to further refine, validate and determine best way to operationalize each of these proposed solutions.
Below is a full list of the proposed solutions and the form the Tiger Team believes may be the best format for use by the industry.
What's the end goal?
Directory: focused on easing ability to identifying endpoints, which currently are located in multiple locations
A National Solution for FHIR Endpoint Discovery
Output format(s) under consideration:
- FHIR Implementation Guide detailing maintenance, validation and retrieval of information from a validated directory
- Recommendation for a central, federally managed, validated provider directory
- Recommendation for federal rules requiring participation in the central directory
Security: solutions focused on determining how to manage permissions and security of millions of patients, payers and providers
UDAP Trusted Dynamic Client Registration | UDAP Tiered OAuth | UDAP JWT-Based Client Authentication| UDAP JWT-Based Authorization Assertions
Output format(s) under consideration:
- Implementer guidance that applies current rules and techniques to FHIR use. Potentially a FHIR IG or other form of guidance
Identity: focused on enabling unique identification of patients/members for requesters Mediated Patient Matching | Collaborative Identifier for Patient | Distributed Identity Management | Networked Identity Management Output format(s) under consideration: - Best practices for Identity Matching Services
- Recommended KPIs for Identity Matching Services
- Best practices for Identity Assurance
- FHIR Implementation Guide for use of Collaborative Identifiers in FHIR queries and pre-query matching
| Scale: focused on enabling a high-volume of FHIR transactions to be consistently and predictably exchanged in a hybrid exchange model Requirements for FHIR RESTful Exchange Intermediaries Output format(s) under consideration: - HL7 FHIR standard for intermediary-to-intermediary exchange
- FAST guidelines for intermediary performance (SLA)
| Exchange: Focused on enabling consistent and reliable transaction exchange Reliable Routing with Metadata Across Intermediaries Reliable Routing Across Intermediaries Using Destination Specific Output format(s) under consideration: - Standard routing metadata definitions to support exchange involving intermediaries, which can be used for any exchange method
- Recommendation for capturing provenance information related to intermediary exchange
| Testing & Certification: focused on ensuring standard conformance ONC FHIR Testing and Certification Output format(s) under consideration: - Requirements for the development of a FHIR testing platform, captured in an RFI to industry participants
- Recommendation to establish an ONC certification program for FHIR implementers
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Versioning: focused on solving issues caused by the use of multiple versions of FHIR across the healthcare ecosystem Supporting Multiple Production Versions of FHIR Output format(s) under consideration: - Content in the Directory FHIR IG (above)
- Request to HL7 for a FHIR version translation capability (to be part of the core FHIR spec)
- Support in the FAST Testing & Certification solution (testing platform) for:
- version-related testing
- capabilityStatement-related testing
- confirmation that FHIR versions are stated in exchanged artifacts
| If you have any further questions, comments or would like more information please contact the ONC FAST Lead: Stephen.Konya@hhs.gov. To stay up to date with FAST, join the FAST TLC LinkedIn Page.
Thank you for your interest in the FAST SME Panel Review Sessions!
- Each of the seven sessions is an invite-only panel of SMEs, identified and vetted by the FAST teams, FAST Chief Architects and ONC FAST Leads.
- A prep session (1-hour) and an discussion focused on the FAST solution evaluation session (3-hours) will be convened via video conference.
- SMEs will be asked to provide their individual expert opinion and guidance on feasibility, unintended consequences, stronger alternate approaches and best implementation path forward for the FAST proposed solutions
For individual session descriptions, and details on general logistics please use the menu items below or continue reading to learn more about FAST and the purpose of the SME Panel Sessions.
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<li><a href='https://oncprojectracking.healthit.gov/wiki/x/hYDuC' target="_blank"><span> 1. FHIR Endpoints Directory</span></a></li>
<li><a href='https://oncprojectracking.healthit.gov/wiki/x/joDuC' target="_blank"><span>2. Scalable Security Solutions</span></a></li>
<li><a href='https://oncprojectracking.healthit.gov/wiki/x/kYDuC' target="_blank"><span>3. Individual Identity Management </span></a></li>
<li><a href='https://oncprojectracking.healthit.gov/wiki/x/lIDuC' target="_blank"><span>4. Reliable Transaction Exchange </span></a></li>
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<li><a href="https://oncprojectracking.healthit.gov/wiki/x/mIDuC" target="_blank"><span>5. Scalable FHIR Testing & Certification Platform</span></a></li>
<li><a href="https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/FAST+Methodology+for+Supporting+Multiple+Production+Versions+of+FHIR+-++Expert+Panel+Discussion" target="_blank"><span>6. Methodology for Supporting Multiple Production Versions of FHIR </span></a></li>
<li><a href="https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/FAST+Scaling+Requirements+for+FHIR+RESTful+Exchange+Intermediaries+-++Expert+Panel+Discussion" target="_blank"><span>7. Scaling Requirements for FHIR RESTful Exchange Intermediaries </span></a></li>
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