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AEGIS, Inc. - Powerful Results. Delivered. SM

Powerful Results. Delivered. OSEHRA Summit Topic: “Why Interoperability Is So Damn Hard” Presenter: Mario Hyland Senior Vice President, AEGIS @ Interopguy. September 5, 2014. 1. AEGIS.net, Inc. - Powerful Results. Delivered. SM. How Important is Patient Safety?. 2.

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AEGIS, Inc. - Powerful Results. Delivered. SM

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  1. Powerful Results. Delivered. OSEHRA Summit Topic: “Why Interoperability Is So Damn Hard” Presenter: Mario Hyland Senior Vice President, AEGIS @Interopguy September 5, 2014 1 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  2. How Important is Patient Safety? 2 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  3. Introduction • AEGIS has been supporting Interoperability Testing within the HealthIT space with VA/HHS (ONC). • HHS/ONC Nationwide Health Information Exchange (NwHIN) (IHE/HL7/OASIS-SAML) • Healtheway Compliance Testing Body (CTB) Certification process for the eHealth Exchange • OSEHRA Open Source Interoperability Work Group with a focus project of the DIL. • NIST HITECH Award HITTI • HL7 Conformance Testing Platform 3 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  4. Challenges facing Standards Adoption Definition of Interoperability (let’s agree to use IEEE). • Participants and Systems Not Ready for Certification or Accreditation • Dependence on Self-Attestation • Understanding the Standards and Specifications • Common (or Consensus based) Interpretation. • Conformance vs Interoperability • Syntactic vs Semantic Interoperability • Interoperability vs Continuous Interoperability 4 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  5. State of Maturity HealthIT Standards Topic: Open Source Development Objective: Adherence to a Standard can be demonstrated thru implementation & testing 5 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  6. Why Interoperability is Challenging • Systems Interoperability Challenges • Organizational exchange of information • Interruption thru Implementation • Common Testing Approach (Happy Path) • Limited Exception Negative Testing (due to dependence on Peer-to-Peer testing) • Change (yes, there will be change) • Standards will be put under new intense pressure. 6 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  7. Robustness Principle • "Be conservative in what you send, be • liberal in what you accept" • http://en.wikipedia.org/wiki/Robustness_principle • Conservative – Happy Path • Liberal – Negative and Exception Path 7 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  8. How to Mitigate Interoperability Risk • We offer a way to Mitigate Interoperability Risk • Because – you will face Interoperability Issues • Interoperability Strategies • Standards based Testing (feedback loop) • Test Early and Test Often • Infuse Interoperability into the Development Cycles thru TDD (Test Driven Development) • Embrace the goal of Continuous Interoperability thru process 8 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  9. How to Integrate TDD into Agile Process 9 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  10. Developers Integration Lab • Developers Integration Lab (DIL) • Self Service Bi-Direction message based test lab • Global accessibility 24x7/365 days • End-to-End Systems Testing • Beyond Happy Path • 70% Negative testing • Cloud Shared Service • Conformance & • Interoperability 10 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  11. DIL Architecture 11 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  12. Standards view thru Statistics • 2013 - 1,387 Implemented Test Cases*: • 522 Conformance Rules applying over 36,000 checkpoints. • Over 77,391 Test Case Executions starting in April 2013 • By Healtheway's CTB candidate participants and vendors. 1,113 Test Cases for NwHIN specifications • The DIL is Actively Exercising Health IT Standards. *ONC S&I Framework ARRA project 12 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  13. DIL Statistics • More than 200+ Organizations Registered on the DIL to test • 45 active Healtheway 2014 onboarding candidates (through Sept.) • Key Findings: • Neither vendors or participants are ready when they started certification testing. • 2-4+ month learning curve to demonstrate compliance to baseline specifications and required message conformance/interoperability expectations. 13 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  14. DIL Statistics • The DIL provides objective analysis of health information standards implementation and exchange problem areas: • DIL execution data record the root cause(s) of conformance/interoperability failures: • System/product failures • Test case definition defect • Specification lacks sufficient implementation guidance 14 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  15. Industry Approach to Interoperability • ONC Roadmap to Interoperability (10 Years) • Patient Privacy (Consent Policy & DS4P) • Unstructured vs Structured Data • Granularity • Data Providence • Leverage Existing HIT Infrastructure • FDASIA Report (Risk Management) • Jason Report (API Architecture) 15 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  16. OSEHRA Interoperability Work Group • goals: • Publish thought leadership pieces • Participate in speaking engagements • Contribute content to the OSEHRA public comment platform • Captures User Experiences and Technical Challenges • Support Rapid Integration of Standards • Influence technology, public policy, laws and regulations • Develop resources, tools and test labs 16 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  17. Contact Us - AEGIS.net, Inc. 2275 Research Boulevard, Suite 500 Rockville, MD 20850 www.aegis.net Mario Hyland Senior Vice President mario.hyland@aegis.net (703) 893-6020 x707 (301) 529-5466 (c) DUNS: 152858358 CAGE Code: 3YHD9 17 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  18. DIL Statistics • HIE participant learning curves vary widely. One example: • Early failures -> Learning - > Refinement -> Success 18 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  19. DIL Statistics • HIE participant learning curves vary widely. BEST CASE: • 2 calendar months from DIL registration to CTB test case results submission for CCHIT review/Healtheway CC onboarding approval. 19 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  20. DIL Statistics • Once past the system configuration learning curve, DIL Test Execution is FAST: • 12 MINUTES to actually execute the test cases required for Healtheway’s 2013 onboarding program. 20 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  21. DIL Statistics • Product Vendor learning curve example: • Early failures -> Learning - > Refinement -> Success • Vendors should take more time—and make use of the DIL more extensively—than individual participants. 21 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  22. State HIE - SUT 22 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  23. DIL Test Account 23 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  24. DIL Test Scenario/Case 24 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  25. State HIE Patient Info (SUT) 25 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  26. DIL Test Results 26 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  27. DIL Exception Reporting 27 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  28. DIL Message Debugging 28 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  29. DIL Message Analyzer 29 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  30. DIL Test History 30 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  31. DIL Role Based Features • Developers Integration Lab (DIL) • Test Users / Participants • Test Case Developers • Test Rules Engine • Community Representatives • Certification / Test Validation • DIL Administrator 31 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  32. DIL Test Case Developer 32 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  33. DIL Test Rules Engine 33 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  34. DIL Community Rep 34 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  35. DIL Certification / Validation 35 AEGIS.net, Inc. - Powerful Results. Delivered.SM

  36. DIL Administration 36 AEGIS.net, Inc. - Powerful Results. Delivered.SM

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