ONC launches Direct Project with pilots in Minn., R.I.

By Mike Miliard
02:02 PM

The Office of the National Coordinator for Health IT announced Wednesday that providers and public health agencies in Minnesota and Rhode Island have begun securely exchanging health information online as part of the Direct Project.

The Direct Project establishes secure, scalable and standards-based specs to transfer medical data to trusted recipients over the Web.

Envisioned as an easy-to-use, Internet-based complement to the Nationwide Health Information Network (NHIN), the Direct Project enables the encrypted "push" of health information from a sender to a known receiver – replacing paper-based mail and fax transmissions.

[See also: Vendors, policymakers discuss 'push' messaging.]

The ONC calls the Minnesota and Rhode Island pilots "a significant step" toward making health information exchange "accessible and practical for all the nation’s clinicians" in support of Stage 1 Meaningful Use requirements.

Speaking on a conference call Wednesday afternoon, IT chief David Blumenthal, MD, said that the "NHIN Direct Project is an essential element" in making the regular electronic exchange of patient data a reality nationwide.

Importantly, he said, it does so "not just for big sophisticated healthcare systems that have hot and cold running health information technology support, but for 'the little guy' – the solo practitioner, the storefront, the critical access hospital. Basically anyone in the world who can use the Internet."

The system, he said, is "simple and elegant and very meaningful for patients and their caretakers."

More pilots in the works
Direct Project pilot programs will also be launched soon in New York, Connecticut, Tennessee, Texas, Oklahoma and California to demonstrate the effectiveness of the streamlined Direct Project approach, which supports information exchange for core elements of patient care and public health reporting.
Designed as part of President Obama’s ‘open government’ initiative to drive rapid innovation, the Direct Project last year brought together some 200 participants from more than 60 companies and other organizations. The volunteers worked together to assemble consensus standards that support secure exchange of basic clinical information and public health data.

With pilot testing of information exchange based on Direct Project specifications being carried out on schedule this year, officials aim toward formal adoption of the standards and wide availability for providers by 2012.

[See also: ONC to begin NHIN Direct testing by year's end.]

Read more about the pilot projects to be launched this year, see next page.

The two pilot programs using Direct Project-based information exchange technology are Hennepin County Medical Center (HCMC) in Minneapolis and the Providence-based Rhode Island Quality Institute (RIQI).

Since mid-January, HCMC, Minnesota’s premier Level 1 Adult and Pediatric Trauma Center, has been successfully sending immunization records to the Minnesota Department of Health.

"This demonstrates the success that is possible through public-private collaborations,” said James Golden, PhD, Minnesota’s state HIT coordinator. “This is an important milestone for Minnesota and a key step toward the seamless electronic movement of information to improve care and public health."
RIQI's pilot project seeks to improve care when patients are referred to specialists by demonstrating direct provider-to-provider data exchange. In addition, RIQI is leveraging Direct Project messaging to securely feed clinical information, with patient consent, from practice-based EHRs to the state-wide HIE, currentcare – detecting gaps in treatment and ensuring the full record is available to all providers.
“All too often, providers do not have the data they need to take the best care of patients they serve," says Laura Adams, president and CEO of RIQI said. "Direct Project allows the Quality Institute to be on the cutting edge – providing health information exchange via currentcare, delivering the efficient rollout of technology through the Regional Extension Center, and enabling and measuring real patient outcome improvements in our Beacon Community."
Other pilot projects to be launched in 2011 include:

  • A Tennessee effort with the Veteran's Administration, local hospitals and CareSpark to provide care to veterans and their families;
  • A New York effort including clinicians in hospital and ambulatory care settings with MedAllies and EHR vendors;
  • A Connecticut effort involving patients, hospitals, ambulatory care settings and a Federally Qualified Health Center with Medical Professional Services, a PHR, and a major reference laboratory;
  • An expansion of the VisionShare immunization data pilot to Oklahoma;
  • A California rural care effort involving patients, hospitals and ambulatory care settings with Redwood MedNet;
  • An effort in South Texas with a collaboration of hospitals, ambulatory care settings, public health, and community health organizations to improve care to mothers with gestational diabetes and their newborns.

Vendor participation
The Direct Project was launched in March 2010 as a part of the Nationwide Health Information Network. Participants include EHR and PHR vendors, medical organizations, systems integrators, integrated delivery networks, federal organizations, state and regional health information organizations, organizations that provide health information exchange capabilities and health IT consultants.

Participating vendors included Allscripts, Cerner, Epic, GE, Google, IBM, Intel, Microsoft, NextGen, Siemens and Surescripts.

Todd Park, chief technology officer at HHS, called the Direct Project "a classic, fantastic, soon-to-be-legendary example of how the public and private sectors can come together in a collaborative, entrepreneurial explosion of mojo, to improve and advance healthcare in America."

Execs from some of those firms also spoke at the press conference Wednesday, and offered announcments of their own. Mark Briggs, CEO of VisionShare, said his company would be making "an investment of up to $50 million over the next year to provide the ability for all physicians, hospitals and other healthcare providers across the country to join the network and transact over Direct."

And Sean Nolan, chief architect of the Microsoft Health Solutions Group, announced that, as of next week, every Microsoft HealthVault account "will be automatically wired up for Direct access" and enabled to automatically accept mails directly from healthcare providers.

That means that "every citizen will have the ability to actually get ... a copy of their electronic health information, into their own hands to use as a more activated patient, as a more empowered patient," said Nolan.