Implementation Capability Worksheet

Version 1.2 includes only optional additions on top of version 1.1; per workgroup call consensus remains intact.

Version 1.2 - 6/1/2010

1. ​Overview
   1. Provide a high-level end-to-end description of your implementation.
   2. Provide a diagram representing the software blocks required for a representative end-to-end system implementation.
   3. Describe the current overall state of the implementation
   4. Describe the working group participants and contributions
2. Benefits/Drawbacks
   1. Outline why you believe this is the best approach to achieving the goals of NHIN Direct.
   2. Outline any Drawbacks to this approach
3. Specific Artifacts
   1. Describe the status of working code.
   2. Describe the status of written specifications.
   3. Describe the status of test tools and cases.
   4. Describe the “production readiness” of the working code – e.g., are errors and edge cases handled, are administrative and monitoring tools available, etc.
4. Abstract Model
   1. Describe how each numbered transaction is supported by the implementation.
   2. Describe how each defined "term" in the abstract model is instantiated in the implementation.
5. User Stories
   1. Describe how each user story is supported by the implementation. ALL stories regardless of priority should be addressed; working code may be focused on the priority 1 items.
6. Security & Trust
   1. Describe how each consensus requirement is supported by the implementation.
   2. (Optional) Provide an assessment of the relevant attack surfaces and mitigations taken in the implementation.
7. Comprehensive HIE
   1. Describe the mechanisms by which the implementation can interact with NHIN Exchange implementations.
8. Other Workgroups
   1. If the implementation deviates from requirements of the Addressing, Content Packaging or Individual Involvement workgroups, describe and explain the reasons here.
9. Cost and complexity of development
   1. Describe what new code is required to create a complete implementation vs. what can be used off-the-shelf.
   2. Describe library and required component availability across platforms and frameworks.
   3. How does this approach integrate with existing mainstream healthcare applications? Describe cost/complexity of integration.
10. Workflow / User Experience
    1. Describe how a small (1-5 provider) practice with limited IT capability might deploy and service the implementation.
    2. Describe how a medium pratice with an outpatient EMR might deploy and service the implementation.
    3. Describe how a large practice / hospital might deploy and service the implementation.
    4. Describe how a patient might participate in the implementation.
    5. Describe how a service provider might create and operate an implementation.
11. Miscellaneous
    1. Metadata Handling
       1. Describe what metadata inherently handled by the implementation
       2. Explain how more complex metadata could be added to the implementation if it is desired
    2. Content Handling
       1. Describe how the implementation deals with unstructured text content.
       2. Describe how the implementation deals with unstructured binary content (e.g., PDF).
       3. Describe how the implementation deals with structured content such as CCx.
    3. Extensibility / Future-proofing
       1. How would this implementation approach extensibility in general to support new use cases?
12. Additional Capabilities
    1. Describe any other relevant capabilities or use cases facilitated by this implementation.

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Version 1.1 Workgroup Call for Consensus:

Organization	Agree	Note
American Academy of Family Physicians	YES	(from call 5/25)
Cerner	YES	(from call 5/25)
Clinical Groupware Collaborative	YES	(carried forward)
Epic	YES
IBM	YES	(from call 5/25)
MedPlus, Inc./Quest Diagnostics	YES	(carried forward)
Microsoft	YES
Secure Exchange Solutions	YES	(carried forward)
VisionShare	YES	(from call 5/25)
VLER
ONC	YES	(from call 5/25)
GE	YES	(from call 5/25)

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This vote is now closed.

Version 1.0 Workgroup Call for Consensus:

Organization	Agree	Note
American Academy of Family Physicians	YES	With stated deletions of 9.4 and 11.3 on the 5/25 call
Cerner	NO	Same objection as ONC below. NHIN-D is not about supporting "query" models. I think the generic "extensibility" question (11.3.2) should be sufficient. Otherwise, a YES.
Clinical Groupware Collaborative	YES	But with caveat that ONC comment and rec below is followed.
Epic
IBM	Yes	Karen Witting: Agree that 11.3.1 should be removed. I recommend that 9.4 be deleted or clarified, see my post at [1]
MedPlus, Inc./Quest Diagnostics	YES
Microsoft	YES
Secure Exchange Solutions	YES
VisionShare	YES	We agree with the comments/requests from Cerner and ONC. Our yes is conditional on removing or significantly altering 11.3.1
VLER
ONC	NO	Remove the "position NHIN for phase 2" sentence and I'm a YES
GE	YES	Per John on the call 5/25