Dixie Baker presented the preliminary recommendations for building blocks that support data exchange in both "push" and "pull" models. The key innovation in Dixie's work is the process for reviewing existing standards for appropriateness, adoption, maturity, and currency.The stated charge of this PowerTeam is:
“Using the NwHIN Exchange and Direct Project specifications as primary inputs, recommend a modular set of transport, security, and content components (“building blocks”) that can be selectively combined and integrated to enable the trusted exchange of content in support of the meaningful use of electronic health record (EHR) technology”I commented strongly during the first presentation of these charts in July, and blogged about it. I would like to believe that it was my blog that caused a 'PowerTeam' to be created to re-examine it. This PowerTeam met on the 11th (3 members if I remember correctly), where I again provided very detailed comments online. I was contacted directly understand and resolve these comments. I also participated in some NwHIN-Exchange meetings where comments were developed and delivered to the PowerTeam. Ultimately trying to provide evidence that the NwHIN-Exchange specifications were more mature than they were being portrayed.
The NwHIN-Exchange folks were very upset at where Authorization Framework landed, as it is critical for Query/Retrieve patterns. They will surely continue to push a better evaluation of this. There is a perception by a few that the Authorization Framework is much harder than it actually is. The specifications mentioned in the 'consider' category are content or uses; so shouldn't have been evaluated.
I have been asked why XDS isn't included - XDS has never been a part of NwHIN-Exchange. The NwHIN-Exchange is about federating local/regional exchanges into a nationwide exchange. This federation is the role of XCA. There has never been any hint of how one might build a local/regional exchange. However as you likely observed, the XCA Query and Retrieve transactions are derived (by IHE) from the XDS Query and Retrieve transactions. Thus a system that knows how to interact with XDS, knows how to interact with XCA. This is a design principle of XCA. So this is normal, and expected.
What is lost in the chart is that XDR is a common thread between Direct and Exchange. The XDR protocol is being heavily used in Exchange, especially by SSA. The XDR protocol holds a special place in the Direct project as well, as it is tangentially endorsed through the specification that shows how to bridge Direct and XDR. Thus “Document Submission” should be recognized as XDR and re-assessed to mature.
|From EHRA White paper|