Interoperable Health Information Exchange Featured at GHIT Conference

Dr. Doug Fridsma | June 14, 2011

The Healthcare Information Management Systems Society (HIMSS) will be hosting its annual Government Health IT (GHIT) Conference June 14-15 in Washington, DC. ONC’s presence at the meeting will highlight the ongoing work being done at the federal and state level supporting interoperable health information exchange and meaningful use of electronic health records. In addition to a closing keynote speech by our new National Coordinator for Health Information Technology, Dr. Farzad Mostashari, I’ll be speaking about our efforts promoting standards-based interoperable health information exchange. Dr. Mostashari’s talk will focus on his vision for the future of health IT and ONC’s efforts supporting innovation and progress in support of meaningful use. 

GHIT will also be hosting a scaled-down Interoperability Showcase, similar to the one at the annual HIMSS meeting this past February. In the showcase, both government and private entities will demonstrate their ability to share information via the Nationwide Health Information Network Exchange (NwHIN), as well as using Direct Project Exit Disclaimer standards and specifications.

I’ve been proud of the significant progress made by the Direct Project over the past year. A key focus of ONC’s health IT agenda is improving outcomes through care coordination and making the patient central to the care process. To make this possible, health care providers need the ability to communicate electronically rather than using the antiquated system of paper and faxes that has been in place for years. The Direct Project was created to enable the secure transport of health messages among trusted care providers and also to patients. This government-sponsored project has seen rapid commercial adoption. As pilots of the project continue to sprout up across the country, there are a growing number of examples where the government is incorporating Direct specifications and standards into their health IT plans, including the Department of Veterans Affairs (VA) and most of the state health information exchanges.

While the progress made by Direct has been exciting to watch, I would be remiss if I didn’t acknowledge the work being done by the Nationwide Health Information Network Exchange. This core group of federal and private entities is indeed growing and onboarding new members. By the end of 2011, it’s estimated that there will be approximately 35 organizations on board and exchanging live information using NwHIN standards and services.

Interoperability Showcase

At GHIT’s Interoperability Showcase, the VA will demonstrate the feasibility of using the Direct Project constructs to enable secure messaging between the VA and Mountain States Health Alliance Exit Disclaimer. This demonstration shows the secure, standards-based transmission of a referral for mammography from a VA medical center to a private sector provider clinic, and the reply from the private sector provider clinic with a text-based report. For this demonstration, the VA will use two Health Information Service Providers (HISPs) based on the Direct Project Reference Implementations that are publicly available from ONC.

In addition to this Direct demonstration, there will be demonstrations among several Exchange partners, including the VA, Department of Defense (D0D), Social Security Administration, Centers for Medicare & Medicaid Services (CMS), and MedVirginia.

The Social Security Administration requests medical information from MedVirginia to support disability determinations. These records are transmitted based on a patient’s authorization to release information, and these two organizations will demonstrate how the agency receives the information using the NwHIN. The information flow is seamless and does not require any human intervention. This exchange of information dramatically reduces time compared to the traditional process.

Another interesting demonstration will focus on the Electronic Submission of Medical Documentation (esMD) pilot. This pilot will allow medical providers to send unstructured medical documentation (PDF) through a NwHIN Exchange gateway to selected Medicare or Medicaid review contractors looking for improper payments. Visitors will learn which health information handlers have been approved by CMS to offer esMD gateway services to providers, and they will also learn which review contractors plan to receive esMD transactions.

Finally, the VA and DoD will be demonstrating the Virtual Lifetime Electronic Record (VLER). President Barack Obama, along with Defense Secretary Robert M. Gates and VA Secretary Eric Shinseki, announced the VLER initiative in April 2009 to enhance the continuity of care for our Service men and women by ensuring that electronic records will transition along with them and remain with them forever. VLER will result in increased information available to clinicians and health care organizations, which will in turn improve the continuity of services and care for our Service Members and Veterans. Initially, VLER will permit authorized users to share health information and eventually enable sharing of electronic health, benefits, and administrative information for Service Members and Veterans. This demonstration will highlight progress being made toward achieving interoperability within the VLER initiative.

I encourage all who are attending GHIT to visit the Interoperability Showcase on June 14 and learn about the pioneering work these groups are doing with respect to health information exchange, and I hope you’ll join National Coordinator Dr. Mostashari and I in a conversation about the future of health information technology.