Overview

PAHISP LLC and NHDS are jointly participating in the "Provider Profiles Authentication", "Digital Signatures" and "E-Clinical Template for PMD" Pilot Projects within the esMD initiative of the Standards & Interoperability Framework.

Technical approach

PAHISP LLC and NHDS are integrating current S&I Framework initiatives and our specific implementation of standards. We are developing a dot net XADES-XL software signing solution for the small practice and for other use case actors. Outputs from an EHR are processed into Microsoft Office and missing elements for the document user story are surfaced to the authenticated use case actor for review and to be filled in via a gap analysis.

Once review or required signing by that use case actor is completed, the signed documents are sent via Direct to the other use case actors for their review and actions. The end output is formatted to meet esMD requirements and sent to CMS.

Objectives

The reduction of missing documents and data fields for patients leading to delays in processing by assisting use case actors in securely sharing data. Long term validation of data by the application of XADES-XL digital signatures. Location of electronic endpoints by registration in a Provider Directory. Development of structured data to meet defined workflows. Application of "lessons learned" in NwHIN development in HHS project portfolio applied to software reuse across various S&I Framework initiatives applied to simplify and lower overhead costs in applying HL7 technology using COTS computing technology for use case actors that were not part of MU incentives.

Stakeholders & Points of Contact

Peter Bachman PAHISP CEM peterb@pahisp.org
Stephen Beller NHDS sbeller@nhds.com

Demonstrated Standards

This pilot will demonstrate:

RFC-3161 Trusted Timestamping Service abd other relevant IETF standards
RFC-5280 as adopted by CMS
ETSI XADES-XL
XML DIG SIG Core
http://www.w3.org/TR/xmldsig-core/
SAML Assertions
https://www.oasis-open.org/standards#samlv2.0
X.500 Directory with LDAPv3 using IHE HPD+ schema
http://www.x500standard.com/index.php?n=Ig.LatestAvail
X.509v3 Digital Certificates
http://www.itu.int/rec/T-REC-X.509-201210-I/en
HL7 C-CDA Stuctured Documents
c=US Realm for Clinical Documents
IHE DSG
Direct Project Applicability Statement for Directed Exchange transport
http://wiki.directproject.org/Applicability+Statement+for+Secure+Health+Transport
e-SIGN ABA and current legal requirements for digital signatures
http://apps.americanbar.org/dch/committee.cfm?com=CL320041
Federal Bridge Policy Frameworks as interpreted by Federal Partners for PKI exchange of data
http://www.idmanagement.gov/documents/federal-pki-common-policy-framework-certificate-authority
Common Criteria Security Profile for target of evaluation
http://www.commoncriteriaportal.org/files/epfiles/st_vid10390-st.pdf

Ecosystem Diagram

external image Digital_signature_schema.gif

Pilot Project Timeline

Anticipated Resources

Success Metrics

Reference Materials

Artifact Name	Artifact	Upload Date	Comments
Pilot Projects Profile	PAHISP NHDS_esMD_PilotProjectProfile_v2_121013.docx Details Download 129 KB	01/10/2014