ONC seeks reusable approach to future NHIN services

By Mary Mosquera
03:21 PM

The Office of the National Coordinator is developing an "interoperability framework" designed to eliminate the need for technical planners to start from scratch in identifying standards and services for future uses of the nationwide health information network (NHIN).

The upcoming start of health IT incentive program has put pressure on the ONC's policymakers to come up with a streamlined approach to identifying specs and standards for new health information exchange features and services that might be created to help boost health IT adoption.

A reusable approach will reduce the time it takes ONC to identify the demand for the standards and then apply them to emerging services, according to Dr. Doug Fridsma, ONC's acting director of ONC's standards and interoperability office.

"One thing that is clear among all the requirements we have for meaningful use "¦ is often we are faced with impossibly tight timeframes to come up with recommended standards or implementation specifications," he said at a meeting of the advisory Health IT Standards Committee Aug. 30.

To design its Standards and Interoperability Framework, ONC will build on the approach it used in setting up NHIN Direct, Fridsma said. NHIN Direct is a set of NHIN specs allowing healthcare providers to perform simple, directed health information exchanges.

In that effort, ONC quickly brought together various public and private healthcare and technology organizations to craft a streamlined version of the NHIN standards and services scaled to help smaller providers meet initial meaningful use requirements.

Fridsma said it is valuable to have a comparable framework in place to come up with a potential new standard or way of exchanging information. "Once all those features have come together, such as transport, content and vocabulary or terminology, then you've got that package," Fridsma said.

To knit together the processes that will make up the new framework, ONC awarded several contracts in the last few weeks for work on technical descriptions of how to deploy standards, reference implementations and testing tools and services.

"Much of this framework is an effort to come up with a common way of representing what the requirements may be," Fridsma said, whether that is based on existing standards of those that "yet need to be created."

He noted, for instance, that there are existing technical descriptions for the standards and services for NHIN Exchange, a set of specs designed to support more complex health data sharing. But there is no sample software or reference implementation that incorporates all NHIN Exchange specifications.

"The goal is to have a one-to-one correspondence between the specifications that we have for the NHIN and for meaningful use and a corresponding piece of software or code that actually implements that," he said.

It's not as much about coming up with production level code that can be downloaded, "but to make sure that we have tested our implementation specification," he added.