PHLIP RNR HUB Presentation at the CDC’s PHIN Conference 2009 September 29, 2009
Posted by gonzalezloumiet in APHL, CDC, Eduardo Gonzalez Loumiet, Interalle, Labpoint, Nebraska, Uber Operations.Tags: APHL, CDC, Eduardo Gonzalez Loumiet, RNR
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Abstract Submission:
PHLIP, the Public Health Laboratory Interoperability Project, surfaced from the laboratory community with the mission to address the need to exchange laboratory orders and results electronically. As the PHLIP initiative matures, many more data exchange partners are expected to participate and apply the standardized content and message structure developed through the PHLIP workgroups. To exchange data between these partners, a direct send PHINMS connection is established between each organization. Although Direct Send is a feasible, secure method of exchanging data, the addition of each new node to the community results in exponential growth of direct connections and maintenance.
Under the direction of the PHLIP steering committee, a pilot project was established to document the requirements for centralized data exchange to meet the growing data exchange needs of the PHLIP community. The requirements pointed to the establishment of two interoperable Route not Read (RnR) hubs. The established RnR workgroup developed a timeline to implement two RnR hubs, one at the Florida Department of Health and one at the Nebraska Public Health Laboratory. The move towards utilizing a multi-hub architecture will reduce the overhead of the Direct Send model by reducing the number of connections for intercommunication of nodes, ease the impact of firewall rules when connecting to trading partners and will make maintenance tasks simpler, such as certificate management. Dual interoperability techniques were developed during the project, one of these solutions is a web services approach to connect the two hubs. Web Services is the basis of NHINs connectivity strategy, so the use of this interoperability technique will position the PHLIP group to take advantage of and participate in national network activity.
This presentation will outline the accomplishments by both Nebraska and Florida to deploy these hubs, and the teams approach to collaboration on information exchange technology, standards, and interoperability.
CDC begins to collect flu data through NHIN September 29, 2009
Posted by gonzalezloumiet in CDC, NHIN.Tags: CDC, NHIN
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By Mary Mosquera
Friday, September 25, 2009
The Centers for Disease Control and Prevention has begun to receive public health reports about cases of H1N1 flu from New York, Indiana and Washington states through the nationwide health information network (NHIN) system.
Dr. Charles Magruder, senior advisor for health information exchange at CDC’s National Center for Public Health Informatics, said the three states’ health departments are linked to CDC through the Connect gateway, health information exchange software developed by a handful of federal agencies.
Connect allows organizations to share health information according to the standards and formats developed for the NHIN. The state agencies use it to relay summarized reports to CDC about incidents of H1N1 flu.
“Now the CDC has the capability to summarize all that summarized, de-identified H1N1 data at the federal level to further examine that,” Magruder said.
He spoke at a demonstration of the project Sept. 24 during Health IT Week sponsored by the Healthcare Information and Management Systems Society (HIMSS). HIMSS also owns Government Health IT.
The state health departments electronically collect patient-level flu data from emergency departments and physicians through the assistance of health information exchanges, which can convert clinical information into a standard format.
The data flow not only from the states but from CDC back to the state health departments, he said. The use of health IT in this manner helps foster public health situational awareness, Magruder noted.
“If we see something of concern, we have an alert network by which we can take the information that we have, and again take it through a standardized process, and inform state health departments and other public health organizations of our findings so they can take quick action,” Magruder said.
Using live data, Magruder demonstrated an interactive map that uses a color-coding scheme to show the number of H1N1 cases across the three states. The map showed a concentration of cases in Spokane and Yakima, Wash.
The map also has the ability to illustrate flu cases nationally or at the local level by demographic variables, over time and across geography, Magruder said.
NextGenWeb Interviews Vish Sankaran of U.S. Department of Health and Human Services September 24, 2009
Posted by gonzalezloumiet in NHIN, Vish Sankaran.Tags: NHIN, Vish Sankaran
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Uber Operations and Vish Sankaran: http://blog.uberops.com/2009/06/15/uber-operations-at-the-lista-d-c-forum/
Verisign to support HHS health network September 23, 2009
Posted by gonzalezloumiet in NHIN, Verisign.Tags: NHIN, Verisign
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Sole-source award is for public-key infrastructure and digital certificates
- By Alice Lipowicz
- Sep 22, 2009
The Health and Human Serv ices Department intends to award a sole-source contract to Verisign Inc. to provide managed public-key infrastructure and digital certificate services for the Nationwide Health Information Network (NHIN).
Verisign is the only provider deemed capable of supplying all the required services for secure, encrypted transmission of electronic medical data on the network, states a notice posted Sept. 17 on the Federal Business Opportunities Web site. Vendors and other interested parties that wish to comment or submit alternative proposals may do so until 5 p.m. EST today.
The NHIN is a pilot project run by HHS’ Office of the National Coordinator for Health Information Technology. It is a network that allows the secure transfer of digital health records between doctors, hospitals, health information exchanges, federal agencies and other entities. To ensure security on the network, HHS said it is necessary to select a certificate authority that is trusted in the field of certificate issuance and secure information transfer.
The certificate authority must be recognized and trusted, be a provider of a full array of services, have a large corporate presence for scalability over time and have a prominent PKI infrastructure, the notice stated.
Under the contract, Verisign will provide the PKI infrastructure and digital certificate services for a year, with two one-year options. The notice lists 17 capabilities and services to be demonstrated by the service provider, including:
- Availability of specialized hardware with certificates that are recognized by the Federal PKI Bridge.
- Dedicated support team.
- Ability to issue certificates rapidly.
- Full reporting and audit trails.
- Ability to support multiple organizations participating in the NHIN.
- Assurance of no errors introduced into the certificate system by the certificate service provider.
“Verisign Inc. is the only known entity which possesses all of the above capabilities, and therefore is considered uniquely capable of satisfying this requirement within the available budget,” the public notice states.
Budget information was not published.
PKI services are becoming more popular with federal agencies. The Defense Department last year authorized broader use of digital certificates and PKI for the purpose of ensuring secure identification on its networks.
About the Author
Alice Lipowicz is a staff writer for Washington Technology.
Chopra: secretary of collaboration September 14, 2009
Posted by gonzalezloumiet in Chopra, NHIN, open source.Tags: Collaboration, NHIN, open source
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By Mary Mosquera
Thursday, September 10, 2009
Soon after Annesh Chopra became the nation’s chief technology officer he promised to use his high-profile perch to advocate for health IT. Since then he has missed few opportunities to press his government and private sector audiences to seek out innovative ways to collaborate on new health services and applications.
President Obama charged Chopra to concentrate on three priorities, and health IT fits in each: to help deliver on healthcare reform through game-changing innovation; collaborate with the private sector to build a reliable digital infrastructure; and push federal agencies to practice openness and innovation in their operations.
To hit these marks, Chopra says he wants to tap the traditional levers of government—what he calls the “gray areas” of research and development, procurement
and grants—as springboards for developing innovative healthcare technologies and applications.
“It’s about marrying ideas with relevance,” he said. “When we listen to providers who actually want to achieve outcomes goals, there may be a different approach. New ideas will emerge that will price differently and structure differently, but will still achieve the goals that have been outlined.”
Chopra brings a mind for public-private collaboration to the national arena from his experience as Virginia’s secretary of technology. His recent history there provides a snapshot of his approach to fostering healthcare innovation.
One illustrative project: In one year, with a grant from the Health Resources and Services Administration, Virginia created a $1 million innovation fund for which Chopra put out a call for healthcare outcome goals and ideas about how organizations would deliver results. The approach was to use the fund to create “coach-able” moments instead of as a straight grant.
“We accepted ideas, and then had a kind of mergers-and-acquisitions period in which people could share each other’s ideas, talk with each other and collaborate,” he says.
As a result, Centra Health of Lynchburg, Va., formed a partnership with the American College of Cardiology (ACC) to take a business problem-solving approach to improving cardiac treatment outcomes. At the time, the ACC had inpatient and outpatient registries that could not be shared. The lack of integration made it difficult to ensure that best practices were followed once patients left the hospital.
Centra engaged local physician leaders to develop a template that prompted physicians to add data and best practices about their cardiac patients’ care while in the hospital and afterward.
“We catalyzed an innovation in the market that is on time, on schedule, delivering preliminary results and sharing data with the American College of Cardiology,” Chopra says.
Going a step further, he believes that the intellectual property Centra developed should also be shared so other companies and organizations can build on it and innovate.
Another idea: entrepreneurs might be able to take raw computer-readable federal data that has become publicly available through the newly established www.
data.gov and use it to design new online applications.
Chopra said the sources of such ideas are not as important as whether they circulate widely. “I am not as wedded to whether the foundation is open source or is a proprietary platform,” he says. “I care more about the sharing and reuse of intellectual property.”
He views the federal government’s Connect portal project as an example of reaching that goal. The Connect software lets government as well as private healthcare organizations access the nationwide health information network. More than 20 federal agencies under the auspices of the Federal Health Architecture project collaborated to build the NHIN gateway application. In April, the group released the source code for the Connect gateway to the open source community.
For Chopra the project is a treasure chest of potential health IT tools and applications. To maintain its momentum, he asked Brian Behlendorf, an open source pioneer and a consultant on Chopra’s Open Government initiative team, to develop an open-source strategy for the portal.
While Chopra’s portfolio is outwardlooking, he is also a member of the administration’s internal health IT policymaking organization. He sits on the HIT Standards Committee, a public-private panel that advises national health IT coordinator Dr. David Blumenthal on health IT standards and certification.
The standards panel and the HIT Policy Committee are working toward finalizing aset of rules providers must follow to qualify for a share of federal health IT stimulus funds.
Chopra is aware policymaking will pave the way to reforms in healthcare payment systems, incentives and programs for wellness and chronic care. “But underneath all the concepts of healthcare reform, and for improving healthcare outcomes,” he notes, “everything that one would want to do in making those changes will have some relationship to a more modern, robust technology platform.”
National network needs incentives too September 14, 2009
Posted by gonzalezloumiet in Nationwide Health Information Network.Tags: NHIN
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FCW Forum — Health IT
U.S. runs the risk of having 50 separate health IT networks — and all the headaches they entail
- By Dr. John Loonsk
- Sep 10, 2009
The politics of health care, business of medicine, concerns about privacy, and sheer technological complexity — all those factors have made it difficult to have effective discussions about the requirements for a common health information network in the United States.
Exchanging patient records and population health data securely is central to the meaningful outcomes ascribed to electronic health records: improving the quality of care, sharing complete patient records among different health care organizations, supporting public health disease monitoring, and reducing medical errors.
Health information exchange, in turn, will not thrive until the many different organizations, subnetworks and medical record systems can come together in a network in which they share common policies and network services. In a common network, they can best use capabilities, share an approach to trusting one another’s information, and achieve explosive network effects, such as those that made the Internet what it is today.
There are a lot of good elements in the extension centers and health information exchange grants recently announced by the Office of the National Coordinator for Health Information Technology in the Health and Human Services Department. That stimulus funding will undoubtedly help advance health IT. Many people now want to see how the different pieces will be brought together to produce the desired meaningful outcomes.
The Nationwide Health Information Network initiative has produced a technical and policy architecture that is intended to bring the pieces together and create a common, secure network for exchanging health data.
As things stand, though, without any specific stimulus funding for NHIN, we run the risk of having more than 50 separate jurisdictional networks, a separate quality reporting network, many separate lab results networks, a separate e-prescribing network, many separate public health networks, separate claims networks and others.
The NHIN architecture efforts began in 2005 and have brought agreement on the initial network services and policies needed to bring together many of these otherwise independent systems and networks. A group of more than 30 organizations established the initial NHIN standards-based technical and policy specifications that are the basis for the NHIN architecture.
The NHIN architecture keeps patient information in a distributed form to address concerns about large central databases. It also enables appropriate data exchange to address patient, provider and population needs. It can support a variety of philosophical approaches to electronic health records.
Whether patients, providers or both eventually manage electronic health records, any approach needs to look up and retrieve information, deliver information to the right place, support patient preferences about how information can be used, and ensure that anonymous population data can be delivered to organizations that need it.
Those common needs helped define NHIN network services. And the services support a common secure health network just as Domain Name System services support the Internet.
Trial implementations have demonstrated NHIN’s viability and utility. Yet strikingly, as of now, none of the more than $36 billion for health IT in the American Recovery and Reinvestment Act is dedicated to advancing any common health information network or ensuring that common network services are available.
As with the Internet, a clear commitment to common network services is necessary to open opportunities for the next steps in health information exchange that can attract health care providers into the technology rather than pushing it on them.
About the Author
Dr. John Loonsk is the chief medical officer for CGI. Previously, he was director of interoperability and standards at the Office of the National Coordinator for Health IT and associate director for informatics at the Centers for Disease Control and Prevention.
Delaware HIE enjoys rare success September 8, 2009
Posted by gonzalezloumiet in Deleware, NHIN.Tags: Deleware, NHIN
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By anne
Created Sep 8 2009 – 8:54am
When it finishes its next transition, the Delaware Health Information Network plans to be that rarest of creatures–a health information exchange that has a long-term, sustainable model in place. And given its usage levels, which are strikingly high, it may just be one of the few HIEs that has a chance of building one.
DHIN has been live since March 2007, and is one of a scant few of the nation’s HIEs that has participated in trials of the federal National Health Information Network. Its usage statistics are impressive: More than half of the state’s doctors use the network, more than 85 percent of lab transactions flow through the system, and 80 percent of hospitalizations are reported through the system. What’s more, surveys suggest that 84 percent of participants in the network think it will improve patient care.
Because of its work with NHIN, the group has received federal funding, on top of state dollars. While the state funding requires dollar-for-dollar private sector matches, DHIN seems to have succeeded in getting them. Furthermore, it also has grants from local health plans. What’s more, it collects fees from members, who pay based on their transaction volume.
The question at hand now is whether it will continue to keep its public-private governance model in place, and what that will mean financially. We at FierceHealthIT wish DHIN luck in making this transition. Clearly, based on other examples nationally, building a long-term sustainable model will be a tricky process.
To learn more about DHIN’s plans:
- read this Healthcare IT News piece [1]
