2009 2010 Webinar Series e Town Hall III

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2009 -2010 Webinar Series e. Town Hall III HITSP - Past, Present, Future –

2009 -2010 Webinar Series e. Town Hall III HITSP - Past, Present, Future – The future of HIT Harmonization and Interoperability Webinar #12 January 22, 2010 | 1: 00 – 2: 30 pm (Eastern) Presenter: John D. Halamka, MD, MS, HITSP Chair Sponsored by the HITSP Education, Communications and Outreach Committee enabling healthcare interoperability 0

Agenda ¨ A brief overview and history of HITSP to date ¨ HITSP’s impact

Agenda ¨ A brief overview and history of HITSP to date ¨ HITSP’s impact on the industry and valuable contributions to the national initiative through its accomplishments ¨ Conclusions and lessons learned about HIT SDOs and harmonization ¨ The future of HIT harmonization and interoperability ¨ Questions and answers HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 1

Mission To serve as a cooperative partnership between the public and private sectors for

Mission To serve as a cooperative partnership between the public and private sectors for the purpose of achieving a widely accepted and useful set of standards specifically to enable and support widespread interoperability among healthcare software applications, as they will interact in a local, regional, and national health information network for the United States. HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 2

HITSP Stakeholders: Who HITSP impacts ¨ Patients ¨ Specialists ¨ Review Boards ¨ Consumers

HITSP Stakeholders: Who HITSP impacts ¨ Patients ¨ Specialists ¨ Review Boards ¨ Consumers ¨ Payers ¨ Practice Healthcare Guidelines Providers ¨ ¨ Employers General ¨ ¨ Suppliers Hospitals Practitioners ¨ Residential Care Providers ¨ ¨ Outpatient Government Agencies Current Stakeholder Participation in HITSP: 800+ organizations 1, 000+ individuals Over 53, 000 volunteer hours HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 3

HITSP Real World Use Sites as of January 2010 ¨ Beth Israel Deaconess Medical

HITSP Real World Use Sites as of January 2010 ¨ Beth Israel Deaconess Medical Center ¨ The New York e. Health Collaborative (BIDMC) ¨ Boston Medical Center ¨ Care. Spark ¨ e. Health Connecticut ¨ Health Bridge and Health. Lin. C ¨ Kaiser Permanente Medical Group ¨ Keystone Health Information Exchange (Key-HIE) ¨ Med. Virginia HITSP – enabling healthcare interoperability Series (NYe. C) ¨ New England Healthcare EDI Network (NEHEN) ¨ North Carolina Healthcare Information and Communications Alliance (NCHICA) ¨ Regenstrief Institute ¨ Social Security Administration (SSA) ¨ Vermont Information Technology Leaders (VITL) 2009 -2010 Webinar Slide 4

View the Complete Set of HITSP Deliverables www. HITSP. org HITSP – enabling healthcare

View the Complete Set of HITSP Deliverables www. HITSP. org HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 5

HITSP was there. . . Supporting from “ONCHIT” to ONC ¨ Covering two administrations

HITSP was there. . . Supporting from “ONCHIT” to ONC ¨ Covering two administrations and three heads of the Office of the National Coordinator David J. Brailer, M. D. , Ph. D National Coordinator for Healthcare IT 2004 – 2006 Robert M. Kolodner, M. D. National Coordinator for Healthcare IT 2006 – 2009 HITSP – enabling healthcare interoperability Series David Blumenthal, M. D. , M. P. P. National Coordinator for Healthcare IT 2009 - Present 2009 -2010 Webinar Slide 6

 Wave 1 of HITSP Accomplishments The Bush Administration Supporting the American Health Information

Wave 1 of HITSP Accomplishments The Bush Administration Supporting the American Health Information Community (AHIC) Use Cases HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 7

Status: Interoperability Specifications Released Accepted Recognized Panel approved for submission to HHS Secretary of

Status: Interoperability Specifications Released Accepted Recognized Panel approved for submission to HHS Secretary of HHS has accepted for a period of testing Secretary of HHS has recognized the IS for immediate implementation Federal projects must use HITSP recognized standards Per Executive Order 13410 HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 8

HITSP Interoperability Specifications (IS) 2006 – 2008 Recognized IS 01 Electronic Health Record (EHR)

HITSP Interoperability Specifications (IS) 2006 – 2008 Recognized IS 01 Electronic Health Record (EHR) Laboratory Results Reporting IS 02 Biosurveillance IS 03 Consumer Empowerment IS 04 Emergency Responder Electronic Health Record (ER-EHR) IS 05 Consumer Empowerment and Access to Clinical Information via Media IS 06 Quality HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 9

During Initial Planning for Interoperable EHRs . . . Something VERY Big Happened Aug

During Initial Planning for Interoperable EHRs . . . Something VERY Big Happened Aug 29, 2005 Hurricane Katrina ¨ The pain and devastating struggles were not forgotten. . . ¨ Next time we WILL do better when someone needs to get healthcare after an evacuation ¨ We have a plan. . . and now that plan is funded for incentives for widespread adoption of EHRs HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 10

HITSP Interoperability Specifications (IS) 2008 – 2009 Recognized Released / Panel Approved IS 07

HITSP Interoperability Specifications (IS) 2008 – 2009 Recognized Released / Panel Approved IS 07 Medication Management IS 08 Personalized Healthcare IS 09 Consultations and Transfers of Care IS 10 Immunizations and Response Management IS 11 Public Health Case Reporting IS 12 Patient – Provider Secure Messaging IS 77 Remote Monitoring IS 107 EHR Centric HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 11

Wave 2 – The Impact Magnifies The Obama Administration Supporting the American Recovery and

Wave 2 – The Impact Magnifies The Obama Administration Supporting the American Recovery and Reinvestment Act of 2009 HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 12

HIT Standards Committee, HITSP, and NCVHS: Shared Members John Halamka HITSP Chair HIT Standards

HIT Standards Committee, HITSP, and NCVHS: Shared Members John Halamka HITSP Chair HIT Standards Committee Vice-Chair HITSP 1, 000+ technical experts Walter Suarez HITSP Board of Directors HIT Standards Committee NCVHS Committee Christopher Chute HITSP Volunteer HIT Standards Committee 23 members James Ferguson HITSP Board of Directors HIT Standards Committee John Klimek HITSP Volunteer HIT Standards Committee NCVHS 26 members HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 13

“Meaningful Use” From existing Interoperability Specifications, determine subset required for “meaningful use” as called

“Meaningful Use” From existing Interoperability Specifications, determine subset required for “meaningful use” as called for in the American Recovery and Reinvestment Act (ARRA) HITSP – enabling healthcare interoperability 14 2009 -2010 Webinar Series Slide 14

Impact & Relationships ¨ HITSP is playing an integral role in the development of

Impact & Relationships ¨ HITSP is playing an integral role in the development of a Nationwide Health Information Network (NHIN) for the United States ¨ Part of Certification Commission on Healthcare IT (CCHIT) certification requirements includes proof of compliance to HITSP specifications ¨ “Recognized” HITSP Interoperability Specifications (IS) are required on all new federal HIT project work and federal contracts. ¨ ARRA and the HITECH act call for “meaningful use” of EHRs. HITSP worked with the HIT to help by providing reusable HIT standards. ¨ IHE Connectathons – Vendors Testing of HITSP Specifications – 2009 IHE Connectathon – 50 vendors – 2010 IHE Connectathon – 75 vendors HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 15

What is ARRA? ¨ Also known as the “economic stimulus package” ¨ Signed into

What is ARRA? ¨ Also known as the “economic stimulus package” ¨ Signed into law by President Obama on February 17, 2009 What is HITECH? ¨ ¨ A portion of ARRA referred to as the Health Information Technology for Economic and Clinical Health (HITECH) Act — TITLE XIII—Health Information Technology — TITLE IV—Medicare and Medicaid Health Information Technology Contains numerous provisions related to Health Information Technology (HIT) and privacy with aggressive timelines for completion HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 16

Work Flow: A High-Level View HIT Policy Committee National Coordinator Secretary HIT Standards Committee

Work Flow: A High-Level View HIT Policy Committee National Coordinator Secretary HIT Standards Committee Recommendations Pilot testing HITSP – enabling healthcare interoperability Series Organizations conducting standards development or harmonization, certification criteria development, or composition of implementation specifications 2009 -2010 Webinar Slide 17

GOAL: Design where the Puck needs to go It is not enough to follow

GOAL: Design where the Puck needs to go It is not enough to follow the puck. . . or go in the direction of the puck. . . We are designing where the puck needs to go! 2015 HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 18

Eight Technology Priority areas for HIT in ARRA 1. Privacy and Security 2. HIT

Eight Technology Priority areas for HIT in ARRA 1. Privacy and Security 2. HIT Infrastructure 3. Certified Health Record 4. Disclosure Audit 5. Improve Quality 6. Individually Identifiable Health Information (IIHI) Unusable 7. Demographic Data 8. Needs of Vulnerable HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 19

2009: The HITSP Tiger Teams ¨ The Office of the National Coordinator (ONC) asked

2009: The HITSP Tiger Teams ¨ The Office of the National Coordinator (ONC) asked HITSP to assist it in meeting its requirements for designating standards that support designated ARRA focus areas for healthcare, and ultimately, that support ARRA’s notion of “meaningful use” — HITSP paused its assigned 2009 work, and directed essentially all efforts toward this end — HITSP organized into focused, quick-moving “Tiger Teams” that accomplished their tasks, and submitted their results to the ONC in mid-July. HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 20

The Power Behind the “HITSP Nation” Technical Committee/Tiger Team Membership – 914 individuals Technical

The Power Behind the “HITSP Nation” Technical Committee/Tiger Team Membership – 914 individuals Technical Committees Number of Members Population Perspective 382 members Consumer Perspective 231 members Provider Perspective 265 members Security, Privacy & Infrastructure Domain 347 members Care Management and Health Records Domain 228 members Administrative and Financial Domain 85 members Tiger Teams Number of Members Clinical Research 147 members Data Architecture 159 members Quality Measures 123 members Consumer Preferences 142 members HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 21

The “HITSP Nation” Powered by 54, 730 Hours in 3 years!! Year # of

The “HITSP Nation” Powered by 54, 730 Hours in 3 years!! Year # of Volunteer Hours 2007 12, 000 2008 19, 000 2009 23, 730 Day Jobs. . . What’s that!! HITSP – enabling healthcare interoperability Series HITSP N ATION 2009 -2010 Webinar Slide 22

EHR-Centric IS Addresses ARRA / HITECH Priority Areas Eight Priority Areas for HIT in

EHR-Centric IS Addresses ARRA / HITECH Priority Areas Eight Priority Areas for HIT in ARRA HITSP Phase 1 Tasks for ARRA 1 2 3 4 5 Security + HIT Certified Disclosure Improve Privacy Infrastructure Health Record Audit Quality EHR Centric Interoperability Specification Security and Privacy Service (Suite) n n Quality Measures project 6 IIHI* Unusable 7 8 Demographic Needs of Data Vulnerable n n Supporting Deliverables Harmonization framework and information/ exchange architecture n Data Element, Template, and Value Set n n n * Individually Identifiable Health Information (IIHI) Unusable HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 23

EHR-Centric IS Facilitates Achievement of ARRA / HITECH Meaningful Use ARRA Title IV (Division

EHR-Centric IS Facilitates Achievement of ARRA / HITECH Meaningful Use ARRA Title IV (Division B) – Section 401 – Medicare Incentives Meaningful Use to Include e-Prescribing Exchange of Information to Improve Quality of Care Reporting Clinical Quality Measures Certified EHR Defined EHR Centric Interoperability Specification n n Security and Privacy Service (Suite) n n HITSP Phase 1 Tasks for ARRA n Quality Measures project n n Supporting Deliverables Harmonization framework and information/ exchange architecture n n Data Element, Template, and Value Set n n HITSP – enabling healthcare interoperability Series n n 2009 -2010 Webinar n Slide 24

 Service Collaborations and Capabilities in Action Base and Composite Standards Capabilities Service Collaborations

Service Collaborations and Capabilities in Action Base and Composite Standards Capabilities Service Collaborations Constructs Component, Transaction, or Transaction Packages HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 25

Multiple Capabilities = Interoperability Specification HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar

Multiple Capabilities = Interoperability Specification HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 26

Education, Communication and Outreach Website HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar

Education, Communication and Outreach Website HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 27

HITSP Education Materials www. hitsp. org/webinars ¨ Archives of 2008 and 2009 Webinar Series

HITSP Education Materials www. hitsp. org/webinars ¨ Archives of 2008 and 2009 Webinar Series ¨ Newly Published Large Wall Posters with description and size posted ¨ HITSP Cross- Reference Matrices — Summary of HIT Standards and HIT Policy Committee Recommendations — Data Elements in CDA, CCD and CCR HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 28

Webinar Series www. hitsp. org/education_outreach Postponed HITSP – enabling healthcare interoperability Series 2009 -2010

Webinar Series www. hitsp. org/education_outreach Postponed HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 29

The HITSP Story in Plain English PLEASE!! What does all this mean to patients,

The HITSP Story in Plain English PLEASE!! What does all this mean to patients, families, and providers? HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 30

2009 -2010 Webinar Series Steve’s Story The story of what standardizing the sharing of

2009 -2010 Webinar Series Steve’s Story The story of what standardizing the sharing of healthcare information between electronic medical records will mean to Patients, Families and Providers. . . and the impact of interoperable Electronic Healthcare Records across our nation Sponsored by the HITSP Education, Communications and Outreach Committee enabling healthcare interoperability 31

Steve’s story. . . Before interoperability ¨ Patient is a 27 -year-old man who

Steve’s story. . . Before interoperability ¨ Patient is a 27 -year-old man who had a brain tumor removed as a child ¨ Over the years, he has been seen by many different doctors and visited many healthcare facilities ¨ Steve’s health information is generally not available to these organizations. Whether paper or electronic, his medical history is not easily shared among providers who need it in order to provide the best care — Data such as registration, patient’s problems, allergies, medications, etc. must be repeatedly collected — Tests and procedures must be repeated due to a lack of previous test results and procedures for comparison HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 32

Healthcare in an interoperable world. . . The Future is Now ¨ HIT data

Healthcare in an interoperable world. . . The Future is Now ¨ HIT data exchange is becoming transparent so that the quality of care delivered by providers and hospitals can be known no matter where the patient is located ¨ Consumers are empowered to — get the right information at the right time — find appropriate, quality and safe care for themselves and their families — assume that repeatable information will be safe and secure while also being accessible by those who need it – before, during and after a visit to a care provider ¨ Care providers are empowered to — provide safe, effective and evidence-based care with information integrated within a clinical care workflow HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 33

HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 34

HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 34

HITSP 2004 -2009: Lessons Learned ¨ The HITSP experience has taught us the value

HITSP 2004 -2009: Lessons Learned ¨ The HITSP experience has taught us the value of bringing stakeholders together to harmonize standards and facilitate adoption ¨ Working with two administrations and 3 leaders at the head of Office of the National Coordinator ¨ Achieving adoption requires much more than a named list of standards — Unclear how to integrate multiple standards — Standards are not constrained for the use case – ambiguous — Implementation guidance is not provided HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 35

HITSP 2009 Accomplishments Include: ¨ Improved HITSP infrastructure definition — Data Architecture (Element, Template,

HITSP 2009 Accomplishments Include: ¨ Improved HITSP infrastructure definition — Data Architecture (Element, Template, and Value Set) — Exchange Architecture and Harmonization Framework ¨ EHR Centric Interoperability Specification — ¨ New Interoperability Specifications — Clinical Research and Newborn Screening ¨ Medical Home Requirements Design and Standards Selection HITSP – enabling healthcare interoperability Series Re-organizes all relevant HITSP constructs around EHR requirements to facilitate ARRA EHR certification and meaningful use goals. ¨ Improved Specifications in Support of ARRA — Security, Privacy, & Infrastructure — Improved Quality Measures 2009 -2010 Webinar Slide 36

Conclusion: HITSP is Foundational Support to ARRA ¨ On July 21, 2009 the HIT

Conclusion: HITSP is Foundational Support to ARRA ¨ On July 21, 2009 the HIT Standards Committee recommended that providers implement the HITSP endorsed standard capabilities, including: — Transmitting prescriptions — Structured data for discharge summary and continuity of care documents — Lab test results ¨ HITSP is performing this critical function credibly in support of ARRA — HITSP support of the newly-formed HIT Policy and Standards Committees ¨ HITSP in the “Real World” series — Medication Management Real World Sites — September 10, 2009 HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 37

Two Key Documents Published January 13, 2010 ¨ ONC Published – “Health Information Technology:

Two Key Documents Published January 13, 2010 ¨ ONC Published – “Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology” (Interim Final Rule – IFR) — Will become Final February 13, 2010 ¨ CMS Published – “Medicare and Medicaid Programs; Electronic Health Record Incentive Program” – (Notice of Proposed Rule Making – NPRM) — Will become Final approximately April, 2010 and be in effect 60 days later HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 38

HITSP Work: Foundational for the IFR ¨ The Interim Final Rule (IFR) contains the

HITSP Work: Foundational for the IFR ¨ The Interim Final Rule (IFR) contains the majority of base standards recommended by HITSP including: — Summaries - CCD — Labs - HL 7 2. 5. 1, LOINC, UCUM, SNOMED-CT — Problem Lists - SNOMED-CT — Immunizations - HL 7 2. 3. 1, CVX — Medications - NCPDP Script 8. 1, Rx. Norm — — Allergies - UNII — Biosurveillance - HL 7 2. 5. 1 Public Health Reporting of Labs - HL 7 2. 5. 1 ¨ The transmission standards - REST and SOAP. Not as specific as HITSP but consistent with its work and a good starting point. ¨ There are still many additional standards and implementation guides up to the HIT Standards Committee to evaluate. — Over the next 6 months, the HIT Standards Committee will work closely with ONC, HITSP, implementation guide writers, and SDOs to fill gaps in the IFR, no doubt referencing HITSP’s products. ¨ The IFR’s Security and Privacy section creates important policy guidance. — As these policies are implemented, constraints will be needed standards. It’s likely the HITSP implementation guidance will be embraced over time. HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 39

HITSP Work: Foundational for the IFR ¨ Two Questions: — Has HITSP's work been

HITSP Work: Foundational for the IFR ¨ Two Questions: — Has HITSP's work been appropriately included? — Was the Tiger Team effort leveraged? ¨ Answer: — The answer to both questions is unequivocally HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 40

HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 41

HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 41

Harmonization and Standards Adoption 2010 and Beyond: What we need for Interoperable Healthcare ¨

Harmonization and Standards Adoption 2010 and Beyond: What we need for Interoperable Healthcare ¨ Engage community of experts from all the SDOs and other key stakeholders in HIT. Do not lose momentum from current engagement. ¨ Continue and intensify efforts to harmonize and integrate standards, providing implementation specifications for all required use cases. ¨ Active and strategic involvement in standards development to ensure U. S. priorities are met and that standards are built in a harmonious fashion. ¨ Continue production experience with HITSP specifications and subsequent improvement of the specifications. ¨ Develop easy to use guidance and continue to educate and reach out to the users and beneficiaries of HITSP specifications. ¨ Provide expert advice, support, and outreach to ARRA adoption efforts such as Regional extension centers, Beacon communities, and workforce training initiatives. HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 42

Recommendations for Harmonization in the Future Obstacles to Harmonization: ¨ No existing vocabulary infrastructure

Recommendations for Harmonization in the Future Obstacles to Harmonization: ¨ No existing vocabulary infrastructure ¨ SDO participation levels ¨ Prioritization ¨ Unclear Process HITSP – enabling healthcare interoperability Series Implementation remedies: ¨ Develop a vocabulary infrastructure ¨ Insure internal consistency and coordination of harmonization infrastructure ¨ Work with SCO Summit/ stakeholders to develop a shared set of priorities for the harmonization of both current standards and prospective ones 2009 -2010 Webinar Slide 43

Milestones and Next Steps ¨ ONC Published – “Health Information Technology: Initial Set of

Milestones and Next Steps ¨ ONC Published – “Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology” (Interim Final Rule – IFR) — Standards IFR for inspection published December 30, 2009 — Standards IFR published in Federal Register January 13, 2010 — Standards IFR becomes EFFECTIVE on February 13, 2010 ¨ CMS Published – “Medicare and Medicaid Programs; Electronic Health Record Incentive Program” – Notice of Proposed Rule Making (NPRM) — EHR Incentive Program NPRM for inspection published December 30, 2009 — EHR Incentive Program NPRM published in Federal Register January 13, 2010 — Public Comment Period open until March 15, 2010 — HIT Standards and HIT Policy Committees have until March 1, 2010 to submit official response to NPRM to ONC and CMS leadership — Anticipated Publishing of Final Rule April, 2010 and becomes final 60 days later HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 44

Lessons Learned – Future Harmonization Recommendations HITSP’s Foundations Committee has compiled a list of

Lessons Learned – Future Harmonization Recommendations HITSP’s Foundations Committee has compiled a list of relevant concerns for future harmonization efforts, based on their work with SDOs, specifically: ¨ Harmonized implementation guide developers must serve the needs of policy makers and implementers; ¨ A variety of expertise is required to develop harmonized implementation guides: — Terminology experts — Messaging and Content Standards — Subject matter experts ¨ A clear “roadmap” outlining the process from requirements to implementation must be provided, including: — Business requirements — Vendor development — User adoption CONCLUSION: The process works, but it remains unclear whether SDOs can and will take steps to harmonize using agreed value sets HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 45

Questions HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 46

Questions HITSP – enabling healthcare interoperability Series 2009 -2010 Webinar Slide 46

Sponsor Strategic Partners www. hitsp. org HITSP – enabling healthcare interoperability 2009 -2010 Webinar

Sponsor Strategic Partners www. hitsp. org HITSP – enabling healthcare interoperability 2009 -2010 Webinar Series Slide 47