First models of NHIN completed

By Mary Mosquera
07:20 PM

The Office of the National Coordinator (ONC) has unveiled the first version of the software that will allow simple information exchange between providers, a crucial enabler for the first stage of meaningful use of electronic health records.

The open source reference model of the standards and services that enable connectivity, which will be available as both Java and .NET formats, will be deployed first in a series of pilots to test it for real-world use, according to Arien Malec, coordinator of the Direct Project, the new name for the old NHIN Direct, a project of the ONC.
The Direct Project is a streamlined version of the nationwide health information network standards set (NHIN), and will offer physicians and small practices the ability to conduct basic health record exchanges. For example, a primary care physician who is referring a patient to a specialist can use the Direct Project to send a clinical summary of that patient to the specialist, and to receive a summary of the consultation.

"As we test out the specifications and learn more from the demonstrations, we'll have more vendor support," he said.

Overall, the Direct Project is a set of technical tools and services that will enable providers to share secure messages, such as patient referrals and care summaries, in one-to-one "push" exchanges with other providers, labs, registries and patient personal health records (PHRs). The sender and receiver are usually known to each other in these simple exchanges, which work somewhat like an e-mail exchange over a health-specific Internet.

"The goal is for universal addressing and secure transport for care processes, which would be a major upgrade from paper and fax," Malec said in a Nov. 29 online presentation sponsored by the National eHealth Collaborative, a public-private partnership that works to foster health information exchange.

If patients had Direct Project addresses, providers could send the patient's data to a PHR, or the patient could transmit information from a PHR to a longitudinal record, Malec said.

The concept of a universal address can serve a variety of tasks, he said. "The ability to have and to control an address that is a pointer to your data home, a universal address, can be akin to an identifier."

The name change from NHIN Direct to the Direct Project will provide a stable name as ONC plans to rename the NHIN. The Direct Project name also demonstrates that some forms of simple exchange occur outside the NHIN, Malec said.

The Direct Project is the collaborative and voluntary work of more than 50 provider, state, health information exchange and health IT organizations. More than 200 participants have contributed to the project, he said. "The Direct Project will broaden exchange, while NHIN Exchange and the Connect software stack will deepen exchange."

Large healthcare organizations and federal agencies, such as Kaiser Permanente and the Department of Veterans Affairs, participate in the NHIN using the comprehensive set of tools and standards incorporated in the Connect gateway for exchange. Federal agencies developed the Connect software, a representation of the NHIN, and released it to the private sector.