Interoperability Hub FAQs

What is the Hub?

The Hub is your way to check if communication through Direct Messaging or a FHIR app is working within your EHR to and from your organization. Think of the Hub as an additional troubleshooting tool that you can use in conjunction with an EHR Source or your ONC-ACB. The Hub offers an unbiased destination to send a Direct Message to and send a Direct Message from, as well as a place to launch a FHIR app query to another EHR source.

Who can use the Hub?

Users of Electronic Health Records (EHRs) whether clinical, administrative, or technical, as well as EHR Developers and ONC-ACBs. The most likely users are technical support staff that are engaged by end users who experience difficulty sending information outbound or receiving information inbound.

What technologies are supported by the Hub?

Direct Messaging and HL7 FHIR.

Why should I register with the Hub?

Registering yourself as an end user allows you access to a dashboard where you can send a direct message to the Hub, launch a FHIR application query, and view activity logs. EHR Developers are also encouraged to register with the Hub.

Why do I have to choose a certified EHR?

Here are two reasons for requiring this as part of registration. First, so that an EHR developer for your chosen EHR can view the activity logs of users who test and use that information in the diagnosis of possible issues. Second and most important, users of certified EHR technology as found on ONC’s CHPL website, are protected when communicating Protected Health Information (PHI) or Personally Identifiable Information (PII) with the Hub. This is a result of the Hub’s designation as toolset utilized by a healthcare oversight agency (Drummond).

If I am using software that is not certified, can I use the Hub?

Not currently. Users of certified EHR technology as found on ONC’s CHPL website, are protected when communicating Protected Health Information (PHI) or Personally Identifiable Information (PII) with the Hub. This is a result of the Hub’s designation as toolset utilized by a healthcare oversight agency (Drummond). Exchanging through non-certified EHR technology puts you at risk for HIPAA violations. Do not include any Protected Health Information (PHI) or Personally Identifiable Information (PII) in your transactions.

Does PHI or PII remain on the Hub?

Yes. The output from the C-CDA scorecard evaluation will remain on the server for a user or EHR developer to review. The file sent as part of a message to the Hub will be deleted immediately after scoring.

Will EHR developers be able to view logs for more than one user?

Yes, EHR developers will have access to view the logs of all users that registered with their software. EHR developers will only be able to see their own products, and not those of other EHRs.

I successfully was able to view a direct message I sent to the Hub. What does that indicate?

You have demonstrated that communication outbound from your Direct Messaging application within your EHR is working properly. This may be useful in further troubleshooting with the receiving organization you are experiencing an issue with.

The C-CDA file that was attached to my Direct Message has no errors and received an “A” grade. What should I do next?

By virtue of receiving an “A”, you have demonstrated that your C-CDA file is compliant and is most likely not the reason for your issue. The issue may be at the receiving EHR destination. Engage your EHR developer for further troubleshooting.

I sent a Direct Message to the Hub but it does not appear in my Hub inbox.

First, determine in your EHR if your system received an MDN (Message Disposition Notification), which signifies that your message was in fact accepted by our endpoint which is hosted by the MaxMD HISP. An IT analyst within your organization should be able to help you determine this as there are varying ways in which your Direct Messaging application notifies end users of success or failure. Part of that process should also include engaging your EHR support team to determine if the message was able to be sent outbound. If you have evidence that your message was received by MaxMD, you may engage Hub support at HIT_Interoperability@drummondgroup.com.

What can I use the FHIR Testing tool for?

The FHIR client application (app) can be leveraged to test that a server hosting FHIR resources is in fact responding to FHIR app queries. You may consider this test if your FHIR app is not receiving results from an endpoint.

If the FHIR client application receives the proper response from the endpoint, what does that signify?

This proves that the FHIR Server endpoint is operational. Engage your FHIR app developer for further troubleshooting.