Prototype Demonstration Furthers Frontier of Health Information Exchange

Whether it’s improving healthcare quality, reducing medical errors, lowering costs or empowering patients, information is at the heart of a successful healthcare system. If physicians and patients can’t share critical information because the data is scattered across systems that can’t communicate with each other, every aspect of healthcare suffers.

Diverse Regions, One Network
On February 14, 2007, the country took a step forward in the direction of a national health information-sharing environment when the CSC and Connecting for Health team successfully exchanged health information through a Nationwide Health Information Network (NHIN) prototype. The team securely transferred healthcare data between MA-SHARE, the Indiana Health Information Exchange and the Mendocino Health Records Exchange, and local public health departments within the regions participating in the CSC consortium – Boston, Mass.; Indianapolis, Ind.; and Mendocino County, Calif.

Building a Broad-Based Team

In November 2005, the CSC-led Connecting for Health team was selected by the Office of the National Coordinator for Health Information Technology (ONC), Department of Health and Human Services, as one of four consortia to create NHIN prototypes. The Connecting for Health team is a broad-based public-private collaborative that includes leading healthcare industry organizations as well as healthcare systems experts in a range of disciplines. (More information on Connecting for Health.)

Making Disparate Systems Talk
Following contract award, CSC orchestrated an industry-wide response to address the complex policy, process and legal issues necessary to build a national network based on open standards and maintaining stringent privacy and security safeguards.

To test the feasibility of information exchange across technically diverse systems, the CSC team chose three disparate regions — Boston, Mass., an urban region with a federated data model; Indianapolis, Ind., with a central database of healthcare information; and Mendocino County, Calif., a rural area using data mirrors to duplicate its data.

The Common Framework: A Consensus for Information-Sharing

At the center of the CSC team’s prototype is the Common Framework, which defines common values, technical standards and policies for sharing information while allowing for local autonomy and innovation, and always protecting patient privacy. The framework, developed by experts in health policy, clinical medicine and information technology, emphasizes a “network of networks” approach based on open systems.

Such an approach means that CSC’s prototype can leverage existing health industry and Internet infrastructure without requiring new networks, specific applications or hardware. This openness is key for an information network such as NHIN intended for use by a huge diversity of organizations and communities across the nation, at different levels of technical advancement.

The Next Steps
The CSC team’s prototype is one of four that ONC will evaluate, after which requests for proposal (RFPs) will be released for trial implementations. It is expected that this will result in up to 10 awards to geographic areas or “data islands,” to do further work in the area of connecting/integrating them.

The architecture for each of the prototypes will be placed in the public domain to stimulate further innovative approaches. The consortia will also share ideas about the prototypes with each other and with the public to accelerate the development of NHIN.

A New Health Information Environment

An important goal of ONC in funding NHIN was to enhance market interest and stimulate investment in electronic health records and clinical data sharing over the next decade. One barrier to such investment has been the absence of standards, which meant expensive systems could get out of date quickly. But as standards and architectures get defined and working prototypes are demonstrated, it is hoped that health organizations will invest with confidence in the new National Health Information Network.

Read an interview with Dr. Robert Wah, CSC’s chief medical officer.

Learn more about Connecting for Health.

Learn more about CSC's Health Services for Government.

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