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blog entry  2009/04/06
Last changed: Apr 06, 2009 17:08 by CONNECT Community Portal Administrator

Monday, April 6, 2009

                                                                      NEWS RELEASE

Contact: HHS Press Office
                (202) 690-6343

Federal Health Architecture Delivers Free, Scalable Solution Helping  Organizations Tie Health IT Systems into the NHIN

The Federal Health Architecture is making software available as a first step  to help public and private health information technology systems communicate to  the Nationwide Health Information Network (NHIN), a federal initiative to  facilitate the electronic exchange of health information.  The Federal Health  Architecture, an E-Gov initiative led by the Office of the National Coordinator  for Health Information Technology (ONC), is making this free software, called  CONNECT, and supporting documentation available at

The ONC has facilitated development of the NHIN, which will tie together  health information exchanges, integrated delivery networks, pharmacies,  government health facilities and payors, labs, providers, private payors and  other stakeholders into a "network of networks." The NHIN provides a mechanism  for previously disconnected systems and exchanges to connect to each other and  share data.  The NHIN uses interoperability standards recognized by the  Secretary of Health and Human Services, as well as public and private sector  specifications, participation agreements and policies. To enable health  information exchanges over the NHIN, the ONC is working to develop the necessary  governance processes and legal framework for participation in the network.

"This software will strengthen our health systems' ability to share data  electronically and provide a wide range of benefits to citizens," said Robert  Kolodner, M.D., National Coordinator for Health Information Technology.   "Benefits include up-to-date records available at the point of care; enhanced  population health screening; and being able to collect case research faster to  facilitate disability claims, as demonstrated by transfers of information  already underway between the Social Security Administration and MedVirginia, a  regional health information organization."

The CONNECT software is the outcome of a 2008 decision by more than 20  federal agencies to connect their health IT systems to the NHIN.  Rather than  individually building software required to make this possible, the federal  agencies, through the Federal Health Architecture, created CONNECT. This shared  software solution can be used by each agency within its own environment. CONNECT  implements the core services defined by the NHIN including standards for  security to protect health information when it is exchanged with other trusted  health organizations.

The agencies built CONNECT using open source components, and will make it  available under an open source license in order to encourage innovation and to  keep costs low.  CONNECT will be available to the entire health care industry,  which is expected to speed NHIN adoption among health care organizations.

"Federal agencies accomplished something remarkable in developing CONNECT.  They looked beyond their individual needs to the needs of the group as a whole,  and they collectively built a solution that provides benefit to all involved  much faster and at a significantly reduced cost than if they had worked  independently," said Dr. Kolodner. "Not only did the agencies deliver a valuable  product for use in the federal government, CONNECT is now an option for any  public or private sector organization that wants to use the solution in the  future to tie into the Nationwide Health Information Network when it goes into  full production."

The Department of Defense, the Department of Veterans Affairs, the Social  Security Administration (SSA), the Centers for Disease Control and Prevention,  the Indian Health Service, and the National Cancer Institute have tested and  demonstrated CONNECT's ability to share data among one another and with private  sector organizations.  In February 2009, the CONNECT software gateway was used  for the first time in a limited production environment when the SSA began  receiving live patient data from MedVirginia through the NHIN.

"Delivering CONNECT has been an enormous project, and we still have a lot of  work to do to move us to large-scale production usage.  But with the support of  the federal agencies and industry, we can accomplish the lofty health IT goals  set at the national level," commented the Federal Health Architecture's program  director Vish Sankaran.

Private and public sector organizations can download CONNECT and use it for  their connectivity needs.  As with other open source solutions, organizations  are encouraged to modify and expand the capabilities of the software.  Although  the download is free, an organization opting to use the solution should be aware  it will be responsible for costs associated with its implementation and  maintenance within its own environment.
More information about HHS health information technology activities is  available at


Posted at 06 Apr @ 5:03 PM by user CONNECT Community Portal Administrator | comment 0 comments
blog entry  2009/04/09
Last changed: Apr 09, 2009 11:00 by Daniel Greunke

SSA's Marty Prahl Interview with Dr. Val regarding NHIN and CONNECT

April 8th, 2009

HIMSS: Sudden Disability Could Cause Your Financial Ruin

Marty Prahl is the lead contracted health IT architect at the Social Security Administration(SSA). His personal experiences have led him to become a passionate advocate for digital data sharing. Several years ago one of his uninsured relatives was diagnosed with a devastating disease. She applied for disability benefits through the SSA but the process took over a year for her approval. During that year her medical condition caused her to lose her job, and she had no means by which to pay her soaring medical bills. The bank repossessed her home, her husband left her, and she had to move in with Marty's family. As they waited for her disability benefits to be approved, Marty tried to make payment on her bills, which put enormous financial stress on his family.

Living through this nightmare galvanized Marty into action - he decided to devote his IT career to speeding up and streamlining the disability determination process. Thanks to Marty's work, and the many people who created the Nationwide Health Information Network(NHIN), the SSA is now participating in an electronic medical record and data sharing network. This means that transfer of the records required to make an individual disability determination (if everyone sending data to the SSA is part of NHIN) can occur in under a minute. If the information supports the disability claim, an approval could be made within 1-2 days.

Prior to becoming part of the NHIN network, the SSA had no choice but to receive information by fax and paper. In order to make a disability determination, all medical records (from all healthcare professionals involved in the patient's are) had to be gathered and analyzed by hand. If a doctor's office didn't send in the patient's medical record in a timely manner, then the process would halt. Of course, compensation for sending records to the SSA didn't generally cover the cost of doing so for the doctor, so the financial incentive to get the documents in was low. It's no surprise that this resulted in wait times of 3 months to 2 years.

But some people simply can't afford to wait - disability determinations are the gateway to Medicare and Medicaid funding, and there are other programs available for those who don't qualify for Medicare and Medicaid. But those programs cannot be accessed until an official disability determination is made by the SSA. There are approximately 3 million new disability claimants annually in the United States - and without electronic data sharing, those people will have to wait for the paper process to run its course.

However, early adopters like MedVirginia, in Richmond, VA are already members of NHIN and can easily share medical records with the SSA. If more hospital systems and providers joined the network, disabled patients would gain rapid access to much needed government insurance benefits, and hospitals would no longer be offering them potentially bankruptcy-inducing "charity care" while they wait for a determination from SSA.

So what should Americans do about this? Spread the word about NHIN, and ask your hospitals to join the network. The software is free and available online (the [CONNECT "open-source" code is here|../]). As for me, I guess I hope that if I'm ever in a terrible car accident I'll be taken to a NHIN participating hospital. A couple of days seems like a much better wait time than 2 years for disability benefits. I think Marty would agree.
Tags: Disability, Disability Benefits, Disabled, Martin Prahl, Nationwide Health Information Network, NHIN, Social Security Administration, SSA
Posted in Expert Interviews |

Posted at 09 Apr @ 10:55 AM by user Daniel Greunke | comment 0 comments
Last changed: Apr 09, 2009 11:08 by Daniel Greunke

Veterans Affairs's Tim Cromwell interview with Dr. Val

April 8th, 2009

HIMSS: Government Gives Away Free Software To Support Medical Records Sharing

by Dr. Val

Tim Cromwell's mother-in-law is 86 years old. Her husband is a Korean War veteran who developed Alzheimer's disease, and receives care from both the VA and private healthcare providers. Because she and her husband take so many medications, they actually replaced their dining room table centerpiece with a collection of orange and white pill bottles. Mrs. Spencer keeps a hard copy of all of her husband's medical records in a large file box that she carries with her on a cart with wheels. She has no alternative for keeping all her husband's providers up to date with his complex care, and lifting and transporting the records has become more difficult for her in her eighth decade.

If this story sounds all too familiar, then you'll be glad to know that the government is facilitating electronic medical and pharmacy records portability. One day it may be possible for Americans to dispose of those hard copy files, knowing that any provider anywhere can access their records as requested.

Tim Cromwell is passionate about alleviating his mother-in-law's need to carry medical records around, and believes the way to do this is through the  US Department of Veterans Affairs' participation in theNationwide Health Information Network(NHIN). Working in compliance with NHIN standards, the Federal Health Architecture group recently oversaw the creation of software  (called [CONNECT|../]) that creates a seamless, secure and private interface with hospitals, and over 20 federal agencies' medical records systems (including the Social Security Administration, Department of Defense, Veterans Affairs, the Centers for Disease Control and Prevention, and the National Cancer Institute).

On April 6, 2009, NHIN released the CONNECT software necessary to make Electronic Medical Records systems interoperable. The software is "open-source" and free to all who'd like to incorporate it into their EMRs. Those who add the free software will be able to share data with NHIN's member groups, which include early adopters like the Cleveland Clinic, Kaiser Permanente, Beth Israel Deaconness Medcial Center, and MedVirginia.

This means that if Mrs. Spencer and her husband receive their care from participating hospitals and federal programs, they'll never have to tote paper records again. But it may take some nudging from patients and healthcare professionals like you to grow the network. If you'd like your hospital to participate in the NHIN network, encourage them to view the NHIN website here.

Posted at 09 Apr @ 11:04 AM by user Daniel Greunke | comment 0 comments
blog entry  2009/04/22
Last changed: Apr 22, 2009 09:40 by Daniel Greunke

Federal Health Architecture moving at warp speed

Perspective: Federal Health Architecture moving at warp speed

When the federal government gets involved, speed to market is not the first thing that comes to mind. The Federal Health Architecture (FHA), however, is a game changer.

FHA coordinates the federal efforts for national healthcare IT initiatives under the Office of the National Coordinator for Health Information Technology. It brought together CIOs and business leaders of 20 federal agencies that have health-related functions to build software that would enable the federal agencies and 16 private-sector entities to exchange health information and eventually become one of the building blocks to help connect to the nationwide health information network (NHIN). "You build the software once under the FHA and agencies can use it multiple times," explained Vish Sankaran, program director.

FHA looked at open source and service-oriented architecture. The contract was awarded to Harris Corp. in March 2008. By September 2008, the Department of Defense, the Department of Veterans Affairs and the Social Security Administration demonstrated health information exchange with 16 private-sector entities using the NHIN-Connect software. In December, the demonstration was expanded to include three more federal agencies - the Centers for Disease Control and Prevention, Indian Health Services and the National Cancer Institute.

In February 2009, the NHIN-Connect went into limited production, with MedVirginia and the Social Security Administration (SSA ) exchanging health information to determine disability benefits.
The MedVirginia/SSA demonstration is the first business case that brings quantifiable value to the provider, said Debbie Somers, senior advisor to the Deputy Commissioner Office of Systems for SSA. Automating the process of accessing records in the physician office has reduced the retrieval time from up to 90 minutes down to real time, she said. With SSA paying out upwards of $30 per request, physicians can create an income stream with little time to invest.

For beneficiaries, the time it takes to determine disability eligibility has been reduced from weeks to days. The ability to retrieve and analyze data from patients' electronic health records ensures that the patient is given the "right treatment at the right location and at the appropriate cost," Somers said.
At the Health Information Management Systems Society's Annual Conference, HIMSS09 in Chicago last week, FHA demonstrated the NHIN-Connect at the Interoperability Showcase, which included the federal agencies from the September and December demonstrations, and the Centers for Medicare and Medicaid Services.
"Everyone is excited to see federal agencies coming together to collaborate," Sankaran said. "We can all be proud of that. We expect our government to function that way." It helps tremendously that the Obama Administration, Congress, states, patients and the industry itself are aligned with the goal to improve the delivery of healthcare services, he said.

Sankaran prefers to look at FHA's work in human terms - serving the needs of disabled citizens, wounded warriors and children with cancer - all beneficiaries of the federal agencies involved in the FHA. Putting real faces on FHA's goals resonates with the general public and drives greater public support, he said.
While FHA has made significant progress in little over a year, Sankaran said there is still much work to be done before moving from limited health information exchange production to full production. Governance, trust, policy and operational infrastructure need to be addressed, he said.

One of the biggest policy challenges involves the privacy and security of federal data, which is tightly controlled through the Federal Information Security Management Act (FISMA). FHA must determine what to do when the Department of Defense moves federal data into the private sector. If the data is still deemed federal data, FISMA must be implemented on the receiving end and required controls need to be determined; no small act, said Sankaran.

Through its healthcare IT partners, FHA has developed the technology for health information exchange, but Sankaran emphasized that technology is first and foremost an "enabler." The platform is for collaboration and innovation; technology is the enabler to collaborate and innovate, he said. "Technology cannot be ahead of policy; policy will drive the technology," he said.

Posted at 22 Apr @ 9:06 AM by user Daniel Greunke | comment 0 comments
Last changed: Apr 22, 2009 09:30 by Daniel Greunke

Open door for open source?

Posted: April 13, 2009 - 5:59 am EDT

(Click here to go directly to article)

Stephen Lieber, the president and CEO of the Healthcare Information and Management Systems Society, sounded pleased with the outcome of the trade association's annual convention, hosted this year at the McCormick Place convention center on Chicago's Lake Michigan shore.

Despite the worst economic downturn since the Great Depression and at least one day of snow and horizontal sleet, the HIMSS show drew about 27,500 attendees, according to Lieber, quoting unaudited final-day figures.
The American Recovery and Reinvestment Act of 2009 - with its tantilizing prospect of as much as $30 billion in healthcare information technology subsidies through 2015 - was clearly the difference between what was an upbeat HIMSS show this year and what might have been a wake by the lake.

Attendance was off only slightly, about 5.5%, from the record 29,100 visitors drawn to sunny Orlando in February 2008 for a HIMSS show held well before the nation's economy fell off a cliff. Since then, travel budgets for IT vendors and providers alike have come under closer scrutiny.

Still, to put the drop in perspective, attendance this year was substantially ahead of the 24,700 at the 2007 HIMSS show in New Orleans, and up slightly from the then-record 25,600 at HIMSS 2006 in San Diego.
This year, Lieber said, "We had more provider organizations represented here than we've ever had. What else could you attribute it to? It's the stimulus. Do we have a history of good educational programming? Sure. Do we have a real good reputation? Sure. But they knew they had to pick up whatever intelligence they could this week," he said, referring to providers.

As it was, medical informaticist William Bria summed up the mood of anticipation and excitement at the daylong Physicians' IT Symposium, one of several pre-conference sessions held April 4, the day before the show officially started its four-day run.

"We are in the middle of one of the most extraordinary years in medical informatics that's ever been," said Bria, a pulmonologist who is the chief medical information officer at the Shriners Hospitals for Children, Tampa, Fla., and president of the Association of Medical Directors of Information Systems. "The work of the past 30 years of applied medical informatics has culminated in this moment."

In the future, payments will be tied more and more to quality and value reporting, according to CMS officials speaking at the show. While payment reform is necessary, it will be "unequivocally linked" to quality reporting as electronic data capture continues to be refined, said Barry Straube, a physician who is director and chief clinical officer in the Office of Clinical Standards and Quality at the CMS. Straube was one of three CMS officials who joined a panel on quality and security issues.

The CMS is in the middle of a number of initiatives testing how to tie quality reporting to financial incentives. It currently uses claims and other administrative data for those projects. While those programs, such as the Physician Quality Reporting Initiative and the Hospital Quality Initiative, have been successful in motivating providers to report, the data capture could be more robust, Straube said. EHRs are the "only way" to responsibly measure quality and value reporting, he said.

Meanwhile, tiny bands of IT insurrectionists trying to establish open-source software in the U.S. healthcare community established two beachheads during the show. Open-source software code is made available to the public for improvement rather than being kept proprietary.

Federal Health Architecture Program Director Vish Sankaran announced at HIMSS that federal officials, working with the Office of the National Coordinator at HHS, had released as open-source software code they developed to create a gateway between more than 20 federal organizations and the proposed national health information network.

Also at the show, open-source developers and officials from the federally supported Certification Commission for Healthcare Information Technology apparently buried the hatchet during a panel discussion. Members of the small, but growing, open-source community have argued on blogs and at other forums that the CCHIT process hampers their development efforts while it favors the work of proprietary software system developers.
CCHIT Chairman Mark Leavitt, however, successfully defused what began as a palpably hostile meeting. He did it by listening to the open-source developers' gripes and recommendations, vowing that he was supportive of, not philosophically opposed to, open-source development, and promising to look into their problems and continue a dialogue with their members. "I think it's a good first step," said David Uhlman, CEO of ClearHealth, a developer of open-source systems. "We'll wait and see if it ends up in a big-door opening."

Robert Kolodner, the outgoing head of the Office of the National Coordinator, was given a standing ovation by several hundred attendees of a session on federal IT programs. Dave Roberts, vice president of government relations for HIMSS, got the crowd on its feet along with Kolodner's key staffers. In March, President Barack Obama named David Blumenthal, a physician and healthcare policy expert, to succeed Kolodner. Blumenthal is scheduled to start later this month.

Posted at 22 Apr @ 9:23 AM by user Daniel Greunke | comment 0 comments
Last changed: Apr 22, 2009 09:37 by Daniel Greunke

NHIN Showcases Information Sharing At Work

(Click here to go directly to article)
Published April 17, 2009

Perhaps one of the best examples of federal information sharing today involves the work currently under way to connect federal health information systems to the Nationwide Health Information Network (NHIN).

As an eGov initiative, the Federal Health Architecture (FHA) coordinates federal efforts to work with more than 20 federal agencies, along with private hospitals and doctors' offices to build and use the NHIN to share information and support patient care, including benefits claims, public health information and numerous other health-related goals. "FHA's efforts are driven by an overwhelming need to improve information sharing," said Vish Sankaran, program director for the FHA.

Of the $2.1 trillion spent annually on healthcare in the U.S., Sankaran reports, the federal government accounts for 40% of that total. "We needed to come together to build a common solution that will help the government reduce overall costs," he explained.

Once in operation, government organizations at all levels, along with private sector healthcare providers will connect to the NHIN to exchange information on the network. Through FHA's efforts, 20 federal agencies have already combined forces to create the open source gateway, now called CONNECT, which provides each agency with a way to tie into the NHIN. Version 1.0 of CONNECT was released last year, and six agencies have already demonstrated its viability.  In late March, Version 2.0 was rolled out to federal agencies and the public to encourage software development, according to Sankaran.

CONNECT enables secure and interoperable electronic health information exchanges with other NHIN participating organizations, including federal agencies, state, tribal and local-level health organizations, and healthcare participants in the private sector. The NHIN will eventually be a vast network of public and private-sector organizations sharing information under clearly defined specifications, agreements and policies.

When CONNECT is ready for full release later this year, agencies will receive a deployable package that includes the CONNECT Gateway, along with enterprise service components and an adapter software development kit (SDK). In the meantime, a growing number of federal agencies will participate in trial implementations that deploy an initial set of services for the secure exchange of interoperable health information.

Government agencies such as the Department of Defense, the Department of Veterans Affairs, the Social Security Administration participated in development and have demonstrated how CONNECT works. For the Social Security Administration (SSA) which processes disability claims for over 2.6 million people every year, the NHIN will provide a way to more quickly evaluate healthcare records and provide benefits to those citizens with disabilities, said Debbie Somers, senior advisor to the deputy commissioner for systems at SSA. If the provider is on the NHIN network, the medical evidence process that once took 90 days or more can be completed in minutes, which dramatically improves speed of treatment, helping the patient concentrate on getting better, rather than gaining social security benefits, she said.

"The NHIN provides us with much needed bi-directional communication," said Barry Rhodes, PhD., acting director for the division of emergency preparedness and response within the Centers for Disease Control.

The flow of information will help practitioners as it won't be just about hospitals reporting conditions. Instead, the CDC will be able to report back to hospitals and providers about outbreaks or other important information, Rhodes explained in an interview with the 1105 Government Information Group.

Each agency has unique reasons for connecting to the NHIN, and will use CONNECT to tap into this nationwide network. Among the benefits of linking to NHIN include:

* Enabling warfighters to receive coordinated care across the public and private sector. Providers will have access to medical records throughout the continuum of care, including when a soldier transitions from active duty to veteran status;
*Ensuring U.S. citizens receive health-related federal benefits to which they are entitled, in a timely manner;
*Enhancing federal, state and local agency response to public health emergencies, including disasters and pandemic diseases;
*Speeding the dissemination of clinical and scientific research results to government, industry and the scientific community;
*Improving regulation of pharmaceutical products and medical devices through faster, more comprehensive and more accurate detection of adverse drug events.

SSA is looking forward to partnering with more health and insurance industry partners on the NHIN in 2009. Providers with electronic health records and health information exchanges can be brought on quickly, said Somers, which "will help further demonstrate the benefits, especially the speed of processing eligibility requests for patients and providers," she said.

Rhodes said the CDC is looking forward to sharing information at least at a summary level with hospitals and practitioners across the nation. For example, he explained, "it would be helpful to be able to provide information on how many cases of the flu are showing up in specific geographic regions at any given time."

Posted at 22 Apr @ 9:40 AM by user Daniel Greunke | comment 0 comments
Last changed: Apr 22, 2009 09:45 by Daniel Greunke

Healthcare Reform Update: This Week's View from Washington, DC

(Click here to go directly to article)

April 17, 2009 - HIMSS09 in Chicago served as the next step on our exciting healthcare reform journey, with over 27,000 attendees from around the world gathering to educate, network and learn.  Key leaders from the Obama Administration, U.S. Congress, state elected officials and other industry stakeholders joined together to discuss next steps.  Now that HIMSS09 has successfully concluded, our focus returns back on the activities in Washington, DC.  Congress is still on recess until early next week, which means Kansas Governor Kathleen Sebelius is awaiting a Senate Finance Committee vote and Senate confirmation before she becomes the next Secretary of Health and Human Services.  All indications are that Governor Sebelius, who has been publicly supported by HIMSS for her active engagement in healthcare IT issues, will be confirmed and will start at HHS by the end of the month.

In the meantime, we understand that Dr. David Blumenthal will officially be on-board as the third National Coordinator for Health IT next week.  Dr. Blumenthal has a full agenda of initiatives he must address in very short order, including completing the HIT Policy Committee membership; announcing the HIT Standards Committee membership; working with CMS on the definition of "meaningful use" of EHRs; defining the minimum requirements for a certified product and who will certify the products (HIMSS supports the continued involvement of CCHIT); and paving the way for widespread adoption through grants to states, local communities, state-sponsored health information exchanges.  Needless to say, his plate is already full.  From our experience, Dr. Blumenthal is prepared to address these many challenges.  We applaud the work ONC has done to date, and look forward to leveraging the subject matter expertise of our large and diverse membership to help Dr. Blumenthal continue to raise the waters for all.

HIMSS is actively engaged in coalescing our stakeholders at the request of the Administration to provide our key input on defining "meaningful use." As you know, HIMSS has had a number of senior level meetings recently in the White House and Executive Branch to discuss the American Recovery and Reinvestment Act of 2009 (ARRA) legislation and next steps. One next step is to engage our members in helping to craft a definition of "meaningful use."Two documents were created by HIMSS for discussion, one for meaningful use by hospitals and a second for physicians as meaningful users. This definition is one of the keys to making Economic Stimulus and Health IT successful and we need your input. HIMSS has set up a discussion forum for this topic on our ARRA landing page. Visitors to the site can either post comments publicly or privately. Regarding the discussion forum, there is no requirement to register or login; however, in the spirit of transparency and open communication, we are asking people to identify themselves, but that's a request, not a requirement.

On April 28 and 29, the Executive Subcommittee of the National Committee on Vital and Health Statistics will be hosting a critical meeting on defining "meaningful use" in which HIMSS will be participating.  NCVHS is the Department of Health and Human Services' statutory public advisory body on national health information policy.

Activities of significance at the federal agency level include an announcement this week by President Obama on the development of a joint virtual lifetime electronic record by the Departments of Defense and Veterans Affairs.  The President's announcement furthers the commitment by the federal government to develop seamless data exchange between the two agencies and their various activities to support information sharing on behalf of military personnel, family members, veterans, and retirees.  We note the announcement is consistent with the considerable advancements that were displayed by the two departments at last week's HIMSS09 Interoperability Showcase.

In addition, the NHIN Connect open source software was officially released by the Department of Health and Human Services Federal Health Architecture in an effort to support data sharing between federal agencies.  To date, seven federal agencies and ten organizations have signed on to utilize or support the NHIN Connect initiative.  We look forward to learning more about new milestones through the NHIN Connect over the coming weeks and months.

As part of the ongoing activities around the ARRA, HIMSS members should be aware of the announcement by the Federal Trade Commission that the agency is seeking public comment on their draft breach notificationregulation that was required in the ARRA.  HIMSS will be coordinating a Board of Directors-approved response by the June 1, 2009 deadline.  If you are interested in participating in a cross-membership initiative to support the HIMSS response, please send your name and contact information to [email protected].

Another ARRA activity of note was the first listening session by the Federal Coordinating Council for Comparative Effectiveness (CER), which was held in Washington, DC, this past Tuesday. The Committee heard stakeholder recommendations on the establishment of research priorities for the $1.1 billion allotted to HHS in the ARRA.  Three panels of stakeholders representing industry, consumer groups, research organizations, and non-profits promoting the well being of individuals coping with specific medical conditions were allotted three minutes to offer recommendations. Panelists recommended the CER ensure:

  • CER data would be transparent and available to all stakeholders, including patients;
  • CER research would not be used at any point by payers to deny medical coverage or services;
  • CER results take into consideration the needs of various demographics, including underserved communities, children, people suffering from chronic conditions and mental illness, and the elderly; and
  • The discretionary $400 million allotted to the Secretary be used to expand available data sources.

Two future listening sessions are expected in early May, as well as an opportunity to provide online comments in advance of the June 30, 2009 report release by the CER.

Finally, one of the casualties of the ARRA is Phase II of the CMS Electronic Health Record Demonstration that was scheduled to start in mid-2010.  CMS announced this past week that Phase I of the demonstration project will continue as planned starting in June, 2009 through May, 2014 in four states.  However, the Phase II activities in Virginia, Alabama, Florida, Georgia, Maine, Oklahoma, and Wisconsin are being cancelled in favor of focusing government resources on achieving the widespread adoption and compliance with meaningful use.  Phase I will work to develop infrastructure and best practices a year in advance of the availability of the 2011 CMS incentive payments for adoption and meaningful use of electronic health records.

HIMSS begins the next series of Economic Stimulus education webinars next week on topics such as planning; privacy and security; broadband; construction; entitlements; grants and loans; and quality, safety and efficiency. For the full listing of topics and dates, visit HIMSS Economic Stimulus Web site.

Posted at 22 Apr @ 9:51 AM by user Daniel Greunke | comment 0 comments
Last changed: Apr 22, 2009 09:50 by Daniel Greunke

NHIN CONNECT Enterprise Service Component (ESC) Code and SDK Released!

(Click here to go directly to article)

Published: April 7, 2009

As previously reported at, the HHS ONC for healthcare IT announced the release of open source NHIN CONNECT Code and SDK at the 2009 annual HIMSS conference. The code may be used under a government BSD, non viral license.  LCDR Steve Steffensen, MC, USN, and Captain (Sel) Emory Fry, MC, USN, were instrumental in working with the FHA to develop the Enterprise Service Component (ESC), described below.

The download site is  This is a significant advance towards the national goal of exchanging interoperable healthcare data, in that the code and SDK will allow software developers to connect federal agency back-end government and commercial healthcare systems to the NHIN.

Per the CONNECT website:

"If the Nationwide Health Information Network (NHIN) is the information highway for health data exchange, CONNECT is the universal on-ramp for federal agencies. CONNECT is a software solution that lets federal agencies securely link their existing systems to the NHIN. More than 20 federal agencies collaborated to build CONNECT through the Federal Health Architecture (FHA), and as a result, agencies are heading down the road toward interoperability.

The Office of the National Coordinator for Health Information Technology (ONC) has been facilitating development of the NHIN, which will tie together health information exchanges, integrated delivery networks, pharmacies, government, labs, providers, payors and other stakeholders into a "network of networks." The NHIN provides a mechanism for previously disconnected systems and exchanges to connect to each other and share data using nationally recognized interoperability standards, specifications, participation agreements and policies. The ability to share data electronically among organizations will provide a wide range of benefits to citizens, among them: having up-to-date records available at the point of care; enhancing population health screening; and being able to collect case research faster to facilitate disability claims.

The CONNECT software is the outcome of a 2008 decision by federal agencies to begin work on connecting their health IT systems into the NHIN. Rather than individually build the software required to make this possible, the federal agencies collaborated through the Federal Health Architecture program to create a single solution that can be reused by each agency within its own environment. The agencies built CONNECT in open source in order to keep costs low when it is deployed in each organization. An additional benefit of developing the offering in open source is that CONNECT has now been made available to the healthcare industry at large. CONNECT will act as an accelerant to promote NHIN adoption and additional innovation in the industry.

The CONNECT Gateway is built on open source technologies and will be made available to the public in March of 2009. Three primary elements make up the CONNECT Gateway:

  • The NHIN Gateway implements the core NHIN services enabling such functions as locating patients at other health organizations within the NHIN, requesting and receiving documents associated with the patient, and recording these transactions for subsequent auditing by patients and others. Other features include authenticating network participants, formulating and evaluating authorizations for the release of medical information, and honoring consumer preferences for sharing their information.
  • The Enterprise Service Component (ESC) provides default implementations of many critical enterprise components required to support electronic health information exchange, including a Master Patient Index (MPI), Document Registry and Repository, Authorization Policy Engine, Consumer Preferences Manager, HIPAA-compliant Audit Log and others. Agencies are free to adopt the default enterprise component implementations packaged in the CONNECT ESC or to plug in existing agency implementations of these service components. This component also includes a software development kit (SDK) for developing adapters to plug in existing systems such as electronic health record solutions to turn on information flows to support the secure exchange of health information across the NHIN. This makes CONNECT a platform for participation in health information exchanges.
  • The Universal Client Framework enables agencies to develop end-user applications using the enterprise service components in the ESC. This makes CONNECT a platform for innovation."

As of 8:00 AM on 7 April 2009, there was very high demand for the software, and HHS put a limit on the number of downloads.  If you cannot get into the download site, keep trying!  E-Health Designs, LLC has subsequently learned that in order to get the code, one must register first with a user name, password, and valid e-mail address.  Upon registration, an e-mail is sent back to the user and he/she must validate that address prior to moving to the next step and being able to actually download the software.  As of 9 April 2009, I was still waiting on the e-mail to arrive so I could validate it.  I presumed that this was an automated process similar to other web sites, however, an FHA representative confirmed to me this afternoon that there is a human involved in the process to send the e-mail, and he/she is back-logged.  FHA is looking to an alternative solution so as to make the downloads more available.

Clinical Informatics Training Programs, Electronic Health Records, Computerized Patient Records, Electronic Medical Records, Healthcare Information Exchange (HIE) and Interoperability, Uncategorized EHR, Government Free Software for Hospitals, Health Information Exchange, HIE, National Health Information Network, Nationwide Health Information Network (NHIN), NHIN, NHIN CONNECT, NHIN CONNECT Enterprise Service Component, NHIN Software, Regional Health Information Officer, RHIO

Posted at 22 Apr @ 9:55 AM by user Daniel Greunke | comment 2 comments
blog entry  2009/04/30
Last changed: Apr 30, 2009 10:21 by Daniel Greunke

(Click here to go directly to the Press Release)


The Health Information Technology Public Utility Act of 2009 will make Health IT more accessible

Washington, D.C. *---*Senator John D. (Jay) Rockefeller IV today introduced legislation that will facilitate nationwide adoption of electronic health records, particularly among small, rural providers.  The Health Information Technology Public Utility Act of 2009 will build upon the successful use of "open source" electronic health records by the Department of Veterans Affairs as well as the "open source exchange model," which was recently expanded among federal agencies through the Nationwide Health Information Network-Connect initiative.

"We need advancements in health information technology across the board to improve the quality of care Americans receive," said Senator Rockefeller, Chairman of the Senate Finance Subcommittee on Health Care.  "To make this happen, we need universal access to affordable and interoperable health information technology - from small, rural health clinics to large, urban hospitals."

Open source software refers to a computer program with unrestricted source code that does not limit the use or distribution by any organization or user.

Senator Rockefeller continued, "Open source software is a cost-effective, proven way to advance health information technology - particularly among small, rural providers. This legislation does not replace commercial software; instead, it complements the private industry in this field - by making health information technology a realistic option for all providers."


Senator Rockefeller's Health Information Technology Public Utility Act of 2009 would:

  • Create a new federal Public Utility Board within the Office of the National Coordinator for Health IT to direct and oversee formation of this HIT Public Utility Model, its implementation, and its ongoing operation.
  • Implement and administer a new 21st Century Health IT Grant program for safety-net providers to cover the full cost of open source software implementation and maintenance for up to five years, with the possibility of renewal for up to five years if required benchmarks are met.
  • Facilitate ongoing communication with open source user groups to incorporate improvements and innovations from them into the core programs.
  • Ensure interoperability between these programs, including as innovations are incorporated, and develop mechanisms to integrate open source software with Medicaid and CHIP billing.
  • Create a child-specific Electronic Health Record (EHR) to be used in Medicaid, CHIP, and other federal children's health programs.
  • Develop and integrate quality and performance measurement into open source software modules.
Posted at 30 Apr @ 10:19 AM by user Daniel Greunke | comment 0 comments
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