Foundation for Interoperable Health Information Exchange Established

The 5th Nationwide Health Information Network Forum, held last week in Washington, D.C., showcased the work of the Nationwide Health Information Network (NHIN) trial implementations which began more than 14 months ago. This work, carried out by members of a public-private "NHIN Cooperative," lays the foundation that will serve as the next step toward secure nationwide interoperable health information exchange, according to a release by the U.S.Dept. of Health and Human Services. By making information available when and where it is needed, nationwide exchange of health information promises to increase health care quality, reducing both cost and medical errors.

Security of information and protection of privacy are essential to information exchange. In his keynote address to open the forum, HHS Secretary Mike Leavitt announced a privacy and security doctrine, made up of eight principles, and a complete toolkit to guide efforts to ensure consumers have protected access to their health information (Privacy and Security Framework). Leavitt emphasized the relationship between these privacy and security measures and the technological advances demonstrated by the NHIN.

As of October 2007, several forces converged to create a broadly-based NHIN Cooperative. HHS awarded contracts totaling $22.5 million to nine health information exchange organizations to begin trial implementations of the NHIN. federal chief information officers recognized the importance of exchanging health information. As a result, the Department of Veterans Affairs, the Department of Defense, the Social Security Administration (SSA), and the Indian Health Service joined the NHIN Cooperative. Since that time, the Centers for Disease Control and Prevention, the National Institutes of Health's National Cancer Institute and six additional grantees from the private sector also joined the effort.

"The work of the Nationwide Health Information Network has come a long way in the last year to create a health information exchange environment that fosters public-private cooperation to empower consumers to benefit from electronic health information,"Leavitt said. "We need to continue to encourage the development of electronic health information exchange that balances each individual's right to access their health information and provide robust protection and security of personal health information."

The trial implementations have engaged communities across the United States and have served to demonstrate interchanges of health information across different types of organizations and regions of the country. While the information exchanged was based on fictitious "patients," the exercises reflected real health care conditions.

"Trial implementations have helped lead the way toward the transformation of health and health care using interoperable health information technology," stated Robert Kolodner, M.D., national coordinator for health information technology.

The two day NHIN Forum provided in-depth discussions and presentations that explored lessons learned by the Cooperative in establishing effective usage agreements, technologies and business models for sustaining the electronic exchange of health information. The experiences reported and learning shared at the forum will make possible the transition of the NHIN from trial implementations to "live" production status. In 2009, the NHIN will come online and begin to exchange "live" data among those organizations that are ready, willing and able to exchange health information using the NHIN specifications and standards. The first of these production partnerships was announced at the forum. Beginning in February 2009, the SSA will work with MedVirginia, a health information exchange organization and member of the NHIN Cooperative, to begin electronically processing Social Security disability determinations. The migration from paper to electronic verification for SSA disability determinations is expected to decrease the time from application to determination from months to minutes. This will result in efficiencies and cost savings, and also improve the quality of life for those applying for SSA disability benefits.