ONC forges partnership for HIE standards

April 7, 2013 in Medical Technology

Rather than trying to create new information exchange governance standards, the Office of the National Coordinator is pursuing the goal of nationwide HIE interoperability and security via a cooperative agreement with Direct Trust and the EHR/HIE Interoperability Workgroup to build on current successes, while sorting out ongoing barriers.

Direct Trust, a nonprofit devoted to secure exchange, and the Interoperability Workgroup, a New York eHealth Collaborative-led coalition, will be working with ONC to develop interoperability accreditation standards and businesses practices aimed at reducing implementation costs and improving privacy and security.

 

It’s part of the ONC’s Exemplar HIE Governance Program, which launched late last year, as the agency looked for alternatives to new HIE governance regulations.

 

In the partnership, Direct Trust will expand work members are doing now in building security and trust frameworks, along with an accreditation program, to help enable vendor-to-vendor and provider-to-provider exchange for meaningful use Stage 2.

 

[See also: ONC offers HIE guidance.]

 

The EHR/HIE Interoperability Workgroup, meanwhile, will “address some of the stickiest implementation challenges facing the exchange of health information,” including patient matching, querying provider directories and the application of governance principles, said Claudia Williams, director of the ONC’s state HIE program.

 

The email-esque Direct exchange promoted by the Direct Trust, said CEO David Kibbe, MD, “is designed to overcome the barriers of organization and IT platforms that have really significantly impeded interoperability and exchanges of health information for really as long as most of us have been working in this field.”

 

One goal of the partnership is to resolve IT issues physicians might otherwise get bogged down with. “We don’t want the doctors and the users of Direct exchange to have to worry about how they manage the digital certificates, who does the encryption, whether or not the encryption is being done based on certificates that are up to date,” Kibbe said.

 

“That is all outsourced, if you will, to the Internet service provider,” he said. “That means that health Internet service provider A — that, lets say, serves a group of providers — and health Internet service provider B — who services another group — need to be able to exchange information and trust one another with respect to privacy, security and trust and identity. And it turns out that contracting between HISP A and HISP B with legal contracts is not a very efficient way to do that at all. As a matter of fact it probably wouldn’t work at scale. Accreditation is a means of allowing those parties to voluntarily take a test and then achieve recognition and seal of approval.”

 

Launched in early 2011, the EHR/HIE Interoperability Workgroup includes members from 19 states, 20 EHR vendors and 22 HIE vendors, and is working on implementation guides for linking HIE platforms and application interfaces, including “plug and play” health IT functionality, as well as a related certification program.

 

[See also: ONC aims to give power to consumers.]

 

The workgroup recently selected the Certification Commission for Health Information Technology, or CCHIT, to test compliance for specifications, to ensure that interfaces between EHRs and HIEs are consistent across multiple states and systems. The end goal of that is a single set of standardized, “easy-to-implement” connections that can support communication among systems.

 

“This cooperative agreement will allow the Workgroup to focus on real-world implementation of Direct Messaging and Query-based exchange occurring in multiple states, further driving consistency and informing the ONC about issues faced in the field,” Dave Whitlinger, New York eHealth Collaborative executive director, said in a media release. “This strong focus on solving implementation hurdles will make it easier for providers to utilize and leverage health information exchange to support care coordination and improved patient outcomes.”

 

The cooperative agreement comes with a grant award of $200,000 for the New York eHealth Collaborative and $285,000 for Direct Trust.







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