Health info network takes another step

After prototypes share data, HHS gets ready for the real thing

Now that prototypes have successfully exchanged data, the initial components of a nationwide health information network are set to go into production in the next year.

The Health and Human Services Department will hire a contractor to develop the system based on standards developed by the public and private sectors.

The HHS-led technical efforts to develop a network of networks to exchange data and perform early health IT functions have progressed significantly over the past year, officials said, culminating recently in demonstrations of four prototypes.

HHS will seek proposals in March or April for a contract to develop a trial implementation of core elements of a nationwide health information network. The agency plans to award the contract in June or July, John Loonsk, director of the Office of Interoperability and Standards in the Office of the National Coordinator for Health IT, said at a recent HHS-sponsored forum.

The contract would incorporate many health IT components developed to date, including the first batch of standards for interoperability, system certification criteria, and prototypes for network architectures.

“We plan to take the good work that’s been done and bring it forward, incorporating activities of state and regional health information organizations,” said Robert Kolodner, interim national coordinator for health IT, Office of the National Coordinator for Health IT.

Loonsk said he expects production activities to start next year. “We think the trial implementation is an important next step, and ... we think we can show some level of production activities in 2008,” Loonsk said.

When the collaborative groups led by Accenture Ltd., Computer Sciences Corp., Northrop Grumman Corp. and IBM Corp. demonstrated their prototypes, they conducted exchanges of data for fictional patients among health care providers depicting early-use activities. These included sharing patient registration, medication information and lab results, and notifying appropriate organizations about public health issues.

HHS awarded an $18.6 million contract in 2005 to the four groups to develop network architectures.

Even under the continuing resolution, HHS will be able to continue the present level of activities, Loonsk said. “[W]e’re not obstructed from a procurement standpoint,” he said.

In the next step, Gartner Inc. of Stamford, Conn., is to evaluate lessons learned and best practices. Gartner will focus on the common interfaces which will let hospitals, physicians and consumers connect to the network, Loonsk said.

The information Gartner collects, analyzes and formulates, and the trial state and regional implementations HHS will fund this year, indicate the direction, said Greg DeBor, partner in CSC’s global health solutions.

“The conclusion of the NHIN projects will re-invigorate regional activities and interest in health information exchange,” he said.

Some of the state and local efforts may have been waiting to see how the NHIN prototypes played out.

The public-private American Health Information Community, which HHS leads, has recommended development of several functions. They include the ability for consumers to access certain clinical information, such as lab results, through their personal health records. Determining and reporting quality measures for hospitals will be developed as an early use for the population health category.

Most consensus activities go through phases of “storming, forming and norming” (brainstorming, formulating plans and making those plans normal procedure), but 2006 included a notable reduction in storming, said Wes Rishel, Gartner’s managing vice president of the company’s health provider practice.

Major components of the health IT activities came together and took their first steps toward norming last year with the production of initial standards, architectures and certification of electronic health records.

“A remarkable consensus has formed on viewing the NHIN as a network of networks, where the subnetworks are RHIOs, multiregional business entities, national health care providers and other agencies, and research,” Rishel said.

HHS accelerated activities to determine standards and certification criteria. Ideally, these activities would be done in sequence and not in parallel, said Janet Marhibroda, CEO of the eHealth Initiative, a collaborative health care industry group.

“I think the administration, recognizing the urgency of this, had them all go forward at once in parallel,” she said.

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