'Light' Version of NHIN UnveiledEases data exchange for smaller players
At the HIMSS Conference in Atlanta March 3, an official with the HHS Office of the National Coordinator for Health Information Technology unveiled plans for NHIN Direct.
The office hopes to draft preliminary, open-source specifications within two months and start real-world tests by October, said Doug Fridsma, M.D., Ph.D., the acting director of ONC's Office of Interoperability and Standards.
The government's official definition of NHIN is "a set of policies, standards and services that enable the Internet to be used for secure and meaningful exchange of health information to improve health and health care."
Several state and regional health information exchanges have been testing NHIN in recent months. One project in San Diego involves the exchange of patient information between Kaiser Permanente and the U.S. Department of Veterans Affairs.
Similarly, NHIN Direct will offer a set of standards, but will be targeted to much simpler data exchanges, such as when a primary care physician refers a patient to a specialist and transmits records, Fridsma said.
"We're creating a light-weight on-ramp" to enable smaller provider organizations to get involved in information exchange," he said. One federal official in the HIMSS audience likened it to "an online version of the intercom."
The ultimate goal of the broad NHIN effort is to enable the secure exchange of patient data nationwide so that, for example, a hospital emergency room in Florida could access the records of a vacationing patient from Oregon.
Enabling "meaningful use"
One motivation for the NHIN Direct project, Fridsma said, is to help clinics and others with limited resources to qualify for the federal electronic health record incentive program called for by the HITECH Act.
To demonstrate "meaningful use" of EHRs and earn incentive payments, participants must be able to exchange clinical data with others. (To view the proposed "meaningful use" rule, click here).
Building a "trust fabric"
Security measures are essential to both NHIN and NHIN Direct, Fridsma stressed, because potential users must have confidence that information exchanged won't wind up in the wrong hands. Thus, organizers are attempting to ensure "a trust fabric permeates all exchange that occurs," he told the HIMSS audience.
"It's critical that we maintain privacy and security as a fundamental element of information exchange," Fridsma stressed.
Although NHIN Direct is designed primarily for smaller organizations to use on their own when completing simple transactions with others, Fridsma acknowledged in an interview that some state and regional health information exchanges may serve as "enabling organizations," helping with implementation.
More information on the new project is available at nhindirect.org.