Health Community Activities

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The first meeting took place on 10 October 2017. Meeting minutes are now available.

On 13 February 2018 FHA provided a status update and recap of their work to date. Meeting minutes are now available.

The next meeting is scheduled for 29 May 2018.

A schedule of meetings for the remainder of the year is currently being developed. The FHA team is also working to decide how to best leverage these meetings going forward. One thought is to hold “office hour” type meetings where they can answer questions from the community and offer guidance with their scenarios/use cases.

Submit Your Use Case


With the adoption of the National Information Exchange Model (NIEM) at all levels of government, there is a growing and unmet demand for clinical health elements to be exchanged outside the typical hospital/clinician setting. For example, domains such as justice, biometrics, agriculture, human services, and emergency response are finding a greater need to standardize the handling of healthcare elements and information. However, the health information technology (HIT) standards are distinctly different from those found in the NIEM.

The Federal Health Architecture (FHA) team, as the NIEM Health Domain steward, is seeking to formalize the relationship between NIEM and the standards reflected in the Federal Health Information Model (FHIM) by aligning NIEM with the commonly used fields, value sets and codes used in clinical standards (e.g. Health Level Seven’s (HL7) Consolidated- Clinical Document Architecture (C-CDA) and Fast Healthcare Interoperability Resource (FHIR); the International Health Terminology Standards Development Organization’s (IHTSDO) SNOMED; the National Library of Medicine’s (NLM) RxNorm, Regenstrief’s LOINC; and the International Statistical Classification of Diseases and Related Health Problems (ICD) ICD-10, etc). This alignment will better position federal, state, and local agencies to obtain and securely exchange specific, key health information with a greater degree of efficiency, consistency, and access control.

Effective summer 2017, FHA has provided dedicated resources to advance alignment between NIEM and the standards commonly used for HIT exchanges. This may also include support for fostering a health-oriented inter-disciplinary community of interest to help guide and potentially govern Health Domain data model content in NIEM.

The FHA team would like to inventory current needs within the NIEM Community and learn about practitioners who have already created Information Exchange Package Documents that use health data elements to ensure the elements and codes are those most commonly used in health IT exchanges. In addition, it would be useful to better understand where other domain’s requirements overlap with health, but where data exchange is not currently occurring and to identify potential barriers to exchange.

If you have created a NIEM-based exchange using health elements, or have identified the need to do so – please share your experience or use case with us at

Specific domains which we believe need to be engaged include:

  • Biometrics
  • Chemical, Biological, Radiological and Nuclear (CBRN)
  • Domestic Nuclear Detection Office (DNDO)
  • Emergency Management
  • Human Services
  • Immigration
  • Intelligence
  • Justice
  • Military Operations

Background: Federal Health Architecture and NIEM

The Federal Health Architecture (FHA) is an OMB E-Government Line of Business (LoB) initiative established in 2004 to bring together the decision makers in federal health IT for inter-agency collaboration with the goal of enabling effective health information exchange (HIE), enhanced interoperability among federal health IT systems and efficient coordination of shared services. FHA also supports federal agency adoption of nationally-recognized standards and policies for efficient, secure HIE.

FHA includes more than 20 federal agencies to advance the national agenda for health IT.

Goals and Target Audience

The goals of this work are as follows:

  1. Define and execute a FY18-FY21 NIEM Health Domain strategy which may include but is not limited to:
    • Catalog and prioritize identified use cases for exchanging health related data outside the healthcare system
    • Determine health IT standards/frameworks which are most relevant to high priority exchanges and seek alignment with the NIEM exchange development process
    • Support a community of interest around the sharing of health data with non-traditional partners with a blending of health/non-health and technical/business people to inform and guide project activities and the health domain, as appropriate
  2. Formalize the alignment between the NIEM and the FHIM, including harmonization of standards where appropriate
  3. Build the relationship between the NIEM and clinical health communities

The critical stakeholders for this project include NIEM users who have a need to exchange clinical health elements to share health related data outside of the common clinical or emergency care setting.


As domain steward of the NIEM Health Domain, FHA has allocated resources to advance and formalize the relationship of NIEM with accepted HIT standards. Success will likely be realized by identifying use cases that satisfy the needs of the NIEM community thus demonstrating value to the healthcare community.

Get Involved

If you or one of your colleagues has created a NIEM-based exchange using health elements, or has identified the need to do so, we need to hear from you. Please share your experience or use case with us at

Want to get connected to the FHA team and join the health domain activities? Please let us know via and someone will be in touch.