Practical Guidance to Implement Meaningful Use Stage 2

Secure Health Transport for Certification and Meaningful Use  (Download pdf)

EHR Association Standards and Interoperability Workgroup (Excerpt)

1. Introduction
Meaningful Use (MU) Stage 2 introduces three transport standards for use in healthcare information transport. The purpose of this paper is to:

  • Summarize the transport standards and their purpose
  • Provide practical guidance to apply one or more of these standards in a MU Stage 2 implementation from a software developer perspective seeking to meet certification
  • Highlight the flexibility allowed by MU Stage 2 in the ways providers may qualify in deploying health information exchange with a certified EHR

2. Summary of Certification Requirements
Section 170.202 of the final rules for Stage 2 certification identifies three transport standards adopted for healthcare messaging. They are:

1. ONC Applicability Statement for Secure Health Transport (incorporated by reference in § 170.299)

This specification discusses the Direct protocol for provider-to- provider messaging. The core component in the technology stack is standard, secure email (SMTP/SMIME).

2. ONC XDR and XDM for Direct Messaging Specification (incorporated by reference in § 170.299)

This specification discusses the application of XDR and XDM to the direct messaging environment and the interaction between the primary Direct Project environment, which uses SMTP and RFC 5322 to transport and encode healthcare content, and the XDR (Web Services push) and XDM (E-mail with metadata) specifications. ONC Transport and Security Specification (incorporated by reference in § 170.299).

3. Standard. ONC Transport and Security Specification (incorporated by reference in § 170.299)

This document defines the primary set of Web Services-based (SOAP) security and transport protocols needed to establish a messaging, security, and privacy foundation for health information exchange.

 

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