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Colleagues,

Thank you to MedTech-IQ member, Luigi Leblanc for this important heads up on a blog post from the always excellent Chillmark Research group ...
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NHIN: The New Health Internet?
October 1, 2009 by John


Chilmark has not been a big fan of the National Health Information Network (NHIN) concept. It was, and to large part still is, a top heavy federal government effort to create a nationwide infrastructure to facilitate the exchange of clinical information. A high, lofty and admirable goal, but one that is far too in front of where the market is today. The NHIN is like putting in an interstate highway system (something that did not happen until Eisenhower came to office) when we are still traveling by horse and buggy. Chilmark has argued for a more measured approach beginning locally via HIEs established by IDNs (our favorite as there is a clear and compelling business case) and RHIOs in regions where competitors willingly chose not to compete on data, rather seeing value in sharing data.

But what might happen if the folks in DC stopped talking about the NHIN as some uber-Health Exchange, but instead positioned it as a consumer-focused platform?

That is basically what happened yesterday at the ITdotHealth event where the new federal CTO, Aneesh Chopra and new ONC CTO Todd Park presented their conceptual idea to a pretty select group who had gathered together to discuss the idea of platforms in HIT to support discrete, substitutable, modular apps. (John Halamka gave a nice write-up of the event in which he participated on the first day).

In somewhat of a re-branding exercise. Chopra and Park are proposing that the NHIN now be viewed not so much as a clinician to clinician care coordination exchange platform but rather one that focuses on the consumer, creating a secure Health Internet to facilitate consumer access to and ultimately control of their Personal Health Information. The basic NHIN, now Health Internet, technology stack remains the same: platform independent, open source, freely available with published standards, etc. that support an independent software vendor’s (ISV) ability to build apps upon the Health Internet stack for consumer consumption (e.g., health & wellness services, PHRs, etc.)...

... At the ITdotHealth event many of the participants (Google Health, HealthVault, MinuteClinic, etc.) stated that they “are in” and will work with the feds to insure that their respective platforms/services will be able to readily connect to and exchange personal health information (PHI ) upon a consumer’s request over the Health Internet. Even EMR giant Cerner voted tentative support for the idea if the Health Internet would assist them in helping their customers meet some of the forthcoming meaningful use criteria that is now being formulated by CMS – Chopra at the June CONNECT event and Park at this one basically inferred that providing the capability for an EHR to connect to the Health Internet would address some aspects of meaningful use...

... Chopra also stated that he has the support of numerous federal agencies (DoD, CMS, SSA, etc.) that they are also on-board allowing their constiuents PHI data to become liquid on the Health Internet...

... The Plan:

At the ITdotHealth meeting, Park and Chopra stated they want to get started on this initiative immediately...

... But there are some challenges ahead for the Health Internet, which include:

The DURSA (Data Use & Reciprocal Support Agreement), which all NHIN (Health Internet) users (data providers, services, ISVs, etc) must sign to participate, stipulates that participants must abide by HIPAA requirements... Now HealthVault is on record stating that they have no problem with HIPAA, but Google is another story where they have been fairly adamant that HIPAA does not apply to them....

... Beyond the feds and HIPAA requirements, there is a morass of state-specific laws as it pertains to the release of PHI ...

... Lastly, there is the issue of bringing awareness to the public. While the vast majority of consumers use Google for a second opinion, very few use the Internet to store, access and share their records. Very few even know what a PHR is. Whenever the topic is raised in conversations with lay people, maybe one person might have heard of Google Health or HealthVault, but it is a rare person indeed that has any understanding what these services are for and why they might be interested in using such a service...

Read on at: http://chilmarkresearch.com/2009/10/01/nhin-the-new-health-internet...

ENJOY!

CC

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