Multi-Party Legal Agreements for Health Information Exchange
NeHC's Special National Health IT Week Stakeholder Forum on Multi-Party Legal Agreements for Health Information Exchange was an opportunity for all stakeholders, especially state decision makers, to understand how multi-party legal agreements can be effective for data-sharing at the state level.
This session was intended to provide decision makers and others with a foundational legal concept for understanding potential applications of multi-party data-sharing agreements. The Data Use and Reciprocal Services Agreement (DURSA) used by the NHIN Exchange was presented as a case study in the development of multi-party agreements and participants learned about those aspects of the DURSA that may be applicable to state level agreements.
Experts from the ONC Office of Policy and Planning and the ONC Office of State and Community Programs, as well as the State-Level HIE Project led by the AHIMA Foundation (technical assistance provider to state HIE grantees), were on hand to answer questions from stakeholders and participate in the discussion.
LEARNING OBJECTIVES: By participating in this Stakeholder Forum, participants:
- Learned about the pros and cons of multi-party legal data-sharing agreements for health information exchange
- Learned about aspects of the DURSA that may impact HIE development for states
- Took away information that will inform state-level plans to consider participation in interstate HIE or the NHIN Exchange
Comment on the Meeting
Presentation Slides
Meeting Transcript
Recorded Webinar
Recorded Video
Stakeholder Questions
- Comment from Andy Rogers: Trust and making it easy to use for busy medical staffs."
- Q from Crystal Fox: Can the presenter say more about why point-to-point agreements have been determined by so many entities to be non-feasible?
- Tweet Q from Gregg Masters: @2healthguru So what is this DURSA thing? http://bit.ly/brmCnZ #nehc #hie
- Q from Ann Waldo: Do Participants have to comply with HIPAA even if they are not subject to HIPAA? (e.g., a non-Covered Entity PPHR)
- Q from d m: can DURSA be used for participating in RHIOs ... in other words not only for participation in the NHIN exchange?
- Q from John Cornelison: Is it reasonable to sign the DURSA, then ALSO add an additional point to point agreement to add additional language?
- Q from John Cornelison: What happens if a party has signed the DURSA then it is revised at the national level? Does one need to re-sign, or can one continue under the previous version?
- Q from John Cornelison: In addition to the primary health organizations, do their key vendors (e.g., one supplying an NHIN gateway with MPI and so forth) need also sign the DURSA?
- Q from Robert Thomson: Is there a review copy of the DURSA available?
- Q from Crystal Fox: Can the presenter say more about why point-to-point agreements have been determined by so many entities to be non-feasible? Why are they even necessary in many cases?
- Q from Ann Waldo: for a state HIE that isn't yet ready to determine if it is ready to participate in the NHIN, would you recommend that the state HIE use the DURSA for its multiparty agragreements?
- Q from Vidit Saxena eClinicalWorks: Are all the different HIEs eventually required to connect to NHIN exhange and follow the same specifications as of NHIN exchange?
- Q from LaRah Payne: Are there continuing opportunities for states and other entities to participate in the NHIN through relationships with the SSA? For example will there be future grants for linking to the SSA?
- Q from Dave Minch: The DURSA seems to be equally applicable to states considering using a common framework for their multi-party agreements within the states. Aside from any provisions needed for specific state requirements, what else would be needed? Am I missing something?
- Q from Melinda Machones (CHIC): We developed a Data Exchange and Support Agreement (DESA) as a multi-party agreement between our providers within our exchange. Its scope is only for exchange within our HIE. We recently became a Participant with the SSA NHIN project and are signing the DURSA Joinder for that. Our strategy is to develop a Rider to our DESA that will be signed by the SSA-involved providers with the flowdown obligations. Is this a recommended strategy? Is there a best practice or better way to address NHIN exchanges for a subset of a regional exchange?
- Q from R B: Please comment on experience with use of DURSA as basis of customization for local/regional P2P and/or multi-party HIE agreements.
- Q from Dave Minch: Specifically considering the federated authentication component of access management, is there a requirement for signatories to have a minimal level of identity verification before issuing individual credentials, or a minimal level of authentication?
- Q from Mike Squires: Any DURSA impact on NHIN Direct?
- Q from Adrian Gropper: How can patients access or preview their own information as accessible over NHIN Exchange?
- Q from Alicia Henning: where can we find the tool kit just mentioned?
- Comment from Robert Thomson: Speaking as a lawyer, I suppose the water is well over the falls on this point, but gosh, it was unfortunate that the term ""trust agreement"" was co-opted for a document that is clearly not a legal trust agreement, but a contract.
- Q from Rebecca Kriz: Exactly which group offers technical support to create these tust agreements, and where can i get more informatin?
- Tweet from Gregg Masters: @2healthguru Excellent question! Will HIE's aggregate under some functional parent? #nehc #hie
- Q from Melinda Machones: We developed a Data Exchange and Support Agreement (DESA) as a multi-party agreement between our providers within our exchange. Its scope is only for exchange within our HIE. We recently became a Participant with the SSA NHIN project and are signing the DURSA Joinder for that. Our strategy is to develop a Rider to our DESA that will be signed by the SSA-involved providers with the flowdown obligations. Is this a recommended strategy? Is there a best practice or better way to address NHIN exchanges for a subset of a regional exchange?
Time: 2:30 - 4:00 pm ET (add to your calendar)
Location: Ronald Reagan Trade Center - International Gateway Room
1300 Pennsylvania Avenue, NW
Washington, DC 20004
Webinar: https://nationalehealthevents.webex.com/nationalehealthevents/onstage/g.php?t=a&d=665349343
Audioconference: (866) 699-3239 or (408) 792-6300
(Please join the event with a computer system first and follow the audio instructions on the screen.)
Access/Event code: 665 349 343
Attendee ID: You will receive this number when you join the event first with a computer connection.
Live Streaming Video: http://www.freedocast.com/nationalehealth