National health information network soon will stand on its own

Health care organizations and federal agencies that piloted a data exchange say it’s ready to separate from the government.

By — Posted March 29, 2012

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A once-conceptual “network of networks” that evolved into the Nationwide Health Information Network Exchange is leaving the direct oversight of the Health and Human Services’ Office of the National Coordinator of Health Information Technology to stand as its own nonprofit organization.

The ONC is making the newly coined “NwHIN Exchange” into an independent, nonprofit, public-private partnership that includes the Dept. of Defense, the Social Security Administration, the Dept. of Veterans Affairs, the Centers for Medicare & Medicaid Services and a host of nonfederal hospitals and health care organizations, as well as local health information exchanges.

Details of the new business model are being worked out, including a sustainability plan. The network is expected to continue evolving as new technologies are introduced and new partners come aboard. The planning process and transfer of power are expected to be complete by the fall. Physicians who use a health information exchange affiliated with the NwHIN Exchange should not notice any changes.

The NwHIN Exchange is not to be confused with NwHIN specifications, which is the portfolio of standards, specifications, tools and software used to standardize health information exchange. The NwHIN Exchange is built using NwHIN specifications, which all health information exchange U.S. networks eventually will adopt to ensure interoperability.

The original members of the NwHIN Exchange were put together to test some of the concepts, standards and technology that came out of the NwHIN specification portfolio, said Doug Fridsma, MD, PhD, director of the Office of Standards and Interoperability for the ONC. It became clear that the exchange of health information was no longer a pilot test but an actual real-world exchange that provided value to participating members.

One of the goals of the ONC was to establish self-sustaining health information exchange networks that provide a business value to their members. The NwHIN Exchange reached a point that it can be one of those self-sustaining networks and no longer need government management.

Dr. Fridsma said the NwHIN Exchange still will serve as a resource to organizations that want to develop their own methods of exchange that meet NwHIN specifications, some of which may not exist yet.

There is no one-size-fits-all approach to the exchange of health data, Dr. Fridsma said. Therefore, physicians hoping to qualify for meaningful use will have a menu of options to meet the data exchange requirements. For primary care physicians, Dr. Fridsma said he envisions many options that will depend on what each physician wants to accomplish.

A large focus of the NwHIN Exchange, for example, has been the coordination of care for veterans being treated at the VA system as well as private organizations contracted to provide care for them. Social Security has used the NwHIN Exchange to help expedite benefit decisions because the exchange allowed medical records necessary for the benefits application process to be sent electronically.

For some physicians, exchange with a government agency might not be necessary, but exchange with fellow accountable care organization members will be needed. Exchange with state public health agencies also might be important. The physician would choose the method of exchange that’s right for him or her. “I want people to use the right tool for the right purpose so they can be successful,” Dr. Fridsma said.

The conversion of NwHIN Exchange to a stand-alone entity coincides with the ONC’s release of the latest version of Connect, an open-source software that enables health information exchange. Use of Connect will allow federal agencies and private health care organizations to exchange data. The newest version supports functions such as patient discovery, document queries and information retrieval.

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