DURSA is a multi-party agreement, a unique agreement that sets out the rules of engagement and commitments that all participants in the National Health Information Network (NHIN) endorse and that all NHIN participants sign as a precondition for membership in the Community. All NHIN participants must sign DURSA to exchange health information through NHIN. DURSA is based on an existing piece of legislation (federal, federal, common) and the current policy framework. The agreement, although referred to as a contract, outlines a framework for a broad exchange of information between a number of trustworthy entities. DURSA builds on the various legal requirements to which participants are already subject and describes the mutual responsibilities, obligations and expectations of all participants under the agreement. All of these responsibilities, obligations and expectations create a framework for a secure exchange of health information and aim to build participants` trust and protect the privacy, confidentiality and security of shared health data. 23 DURSA adopts HIPAA privacy and security rules as minimum requirements to enable the effective exchange of health information in a manner that protects data privacy, confidentiality and security. When an application is based on a purpose for which a HIPAA authorization is required (for example. B for determining SSA benefits), the applicant participant must send a copy of the authorization with the data request. Applicants are not required to send a copy of an authorization or consent if they request data for processing. CalDURSA is a multi-party data exchange agreement that sets out common policies, procedures and operational practices that are necessary for the exchange of reliable health information in California. This is the basis of the California Trusted Exchange Network (CTEN).
6 NHIN ArchitectureParticipants currently in the NHIN are connected entities that support a gateway that meets NHIN requirements and allows its users/systems/networks/connected communities to exchange information among other NHIN participants. Participants are included in a «list» so that other NHIN members know the types of messages supported and where they can respond to requests 6 16 participants in productionL`ASHSA explicitly assumes that each participant is in «production» and therefore has already entered into trust agreements with its agents, collaborators and data links (end users, data providers, systems and networks, etc.). These agreements and confidence-building policies must provide the necessary conditions to support the framework of trust that the hard framework should be. 11 Data Use and Mutual Support AgreementA comprehensive, multi-party trust agreement, signed by all authorized organizations wishing to exchange data between NHIN participants, requires signatories to comply with common conditions defining participants` obligations and trust structure to support the privacy, confidentiality and security of the health data exchanged. As a living document, the agreement has been amended over time 11 According to The project, CalDURSA is compatible with The Sequoia Project`s DURSA, allowing organizations to easily participate in both the CTEN and eHealth Exchange.