Government health IT committee notes NHIN progress
The Capitol Hill Steering Committee on Telehealth and Healthcare Informatics held a meeting last week in Washington, D.C., to discuss recent progress toward establishing a nationwide health information network (NHIN).

The committee, founded in 1993 by Sen. Kent Conrad, D-N.D., hosted presenters Vish Sankaran, program director for Federal Health Architecture (FHA); Jim Traficant, vice president of healthcare solutions at Harris; David Riley with FHA CONNECT Initiative; and Denny Porter, executive in residence at the Institute for e-Health Policy.

The presenters cited recent statements by David Blumenthal, MD, national coordinator for health IT, who said that meaningful use incentive payments, under the Recovery Act, may be linked to the healthcare provider's ability to connect to the end program, stressing the importance of establishing an NHIN.

Traficant noted that if healthcare professionals do not have the information needed at the point of care, they have to generate the information themselves.

"Digitizing this system won't be enough. We must integrate it. The only hope for turning data into knowledge in healthcare is to integrate the health enterprise," he said.

Sankaran said that the goal of the FHA is to examine how true interoperability for health information can be achieved to improve efficiencies in government health IT operations. Out of this charter, the FHA CONNECT had seven government agencies demonstrate health information exchange (HIE) in 2008. He noted that the FHA's goal is to begin a process to be adopted and disseminated by private industry--which has led 20 vendors to work with FHA.

Riley described the FHA CONNECT solution as a tool for HIE, which has three open-source components:
  • Gateway component, which implements the core services defined by the NHIN;
  • Enterprises Services component grew out of the need for various agencies to plug their current EMR into an adapter service. (He also noted that they are looking to include a master patient index into this service); and
  • Universal Client component, which allows the user to work in their existing EMR system, but increase its capabilities through desktop applications, in order to enhance or adjust its current capacity.

The software was released to the public in April at the HIMSS conference. He also announced the first code-athon for the open-source FHA CONNECT solution will take place in August.

Among other things, Porter highlighted the need for a Federal Health Record Gateway that would make EMRs readily available online on a single secure portal.

"HIE has to become a commodity, and the data has to be the value," Sankaran said.

He outlined three primary elements of an HIE, which included making the process easy and standardized, ensuring that health IT is an integral part of all care being provided and innovating once the proper amount of data has been collected.

In additional to an integrated, interoperable digitized system, Traficant said that the current healthcare system needs to transfer lessons learned in other industries to the healthcare environment. Also, in order to control costs, he said that healthcare needs a secure, private enterprise in which the patient controls who accesses their information, leading to transparency in "pricing, performance and enabling us to attack fraud [and] waste."

Traficant cited the lower reimbursements that stemmed from the Deficit Reduction Act (DRA) of 2007, as a failed utilization of data. He noted that DRA "hurt every radiology company in the industry from the smallest companies all the way up to GE [Healthcare] and Siemens [Healthcare]." However, he said that "it didn't solve the problem, because we converted to a consumption model in order to make up for reimbursement reductions--we, instead, went to volume."

All the presenters highlighted the importance of using health IT to improve patient care and control costs. As Traficant put it, "The healthcare system is the greatest economic threat to this generation...and we will continue to be at risk until we implement completely interoperable health IT standards."