Goal: To demonstrate capabilities of the overall SHARP program with contributions from each of the individual SHARP participants.

Overview of Contributions
The Pan-SHARP projects grew out of discussions at an ONC meeting in 2011 that called for a multi-faceted project to which each of the four SHARP teams and the NIH SHARP affiliate could contribute. The topic selected was Medication Reconciliation (MR), the process of consolidating all of a patient’s medications into a single well-reviewed list. Medication errors account for many deaths and MR is a key step to reduce these losses and provide better patient care.

1. The SHARPS project contributed a security architecture for a centralized MR as part of the SHARP project MEDICATION LIST RECONCILIATION-SECURE MANAGEMENT. In this project SHARPS team members coordinated with representatives of the other SHARP teams and NIH affiliate to produce a collection of systems that contributed to MR. The specific role of SHARPS in this project was to demonstrate how existing security tools and protocols could be used to secure parts of the MR process such as the collection of digitally signed and encrypted documents representing for the medication lists. This project showed that tools like OpenSSL are adequate to perform key technical transformations, but that there will be future challenges with issues like distinguishing between “mechanical provenance” like the signatures on documents and the “clinical provenance” like the reliability of the origin of information (reported by the doctor or by the patient?). After the first phase of the Pan-SHARP project, the various SHARP teams pursued specific area of technical interest based on their focus areas.

2. CONTINUITY OF CARE DOCUMENT (CCD) DE-IDENTIFICATION focused on the problem of taking persistent documents like CCDs that are produced mainly for primary care and showing how a suitable transformation could de-identify these documents. The project produced a set of specifications for de-identifying CCDs to achieve HIPAA Safe Harbor and prepared for a validation study at a hospital.