The Office of the National Coordinator is finalizing the details and design of NHIN Direct, the health information exchange tool-set it is preparing to help physicians and small practices share basic healthcare records securely over the Internet.
During the summer, ONC will finish the protocols, additional health information services and underlying technical design of NHIN Direct, according to Douglas Fridsma, MD, ONC's acting director of interoperability and standards.
ONC expects to release specifications for NHIN Direct late this summer so that it can be tested in real world settings through the fall, he said June 16 at the Government Health IT conference in Washington, D.C. "Real-world demonstrations help us tackle problems related to the specific interchange we're looking for," he said.
NHIN Direct is a streamlined version of the standards and services that will required to establish a nationwide health information network. ONC hopes the simplified exchange tools will help physicians and small providers meet meaningful use requirements for basic exchanges in 2011.
Clear objective
In his remarks, Fridsma emphasized that NHIN Direct has a limited but specific objective. "The NHIN Direct project only solves one piece of the puzzle," he said. "We're focused on secure routing of information from one provider to another or lab or hospital," he said.
The technical work involves breaking down what constitutes a simple health information message. "Constructing that message means we have to talk about vocabularies, document standards and messaging," Fridsma said.
"We have to figure out how to write a letter and package it up and put it in the envelope. And you have to figure out where to send it, and may have to look it up to find the address where to send it."
ONC is still deciding what additional health information functions, including the level of provider look-up, might be included in NHIN Direct. More robust features, such as advanced directory, authentication and identity services, are offered in NHIN Exchange, for which ONC and its partners have been developing tools and specs for several years.
Fridsma was bullish about progress in the use of NHIN Exchange among government agencies, hospitals and more sophisticated healthcare organizations.
He said the number of organizations using the NHIN Exchange tool-set would "likely triple over the next nine months," from its current list of participants that includes the Social Security Administration, Veterans Affairs and Defense departments, and most recently the Centers for Medicare and Medicaid Services.
Fridsma said he believed NHIN Direct would lead smaller providers into more complex health information exchange associations and exchanges. "I think it will engage more people in information exchange and get them on the escalator to more robust kinds of exchanges," Fridsma said.
