NHIN Direct

OpenEMR Development
1

anonymous wrote on Friday, June 25, 2010:

John,

Have you heard of CONNECT? CONNECT is an open source software solution that supports health information exchange – both locally and at the national level. CONNECT uses Nationwide Health Information Network (NHIN) standards and governance to make sure that health information exchanges are compatible with other exchanges being set up throughout the country.

This software solution was initially developed by federal agencies to support their health-related missions, but it is now available to all organizations and can be used to help set up health information exchanges and share data using nationally-recognized interoperability standards.

CONNECT can be used to:

    * Set up a health information exchange within an organization
    * Tie a health information exchange into a regional network of health information exchanges using NHIN standards

Best part of CONNECT is that its Open Source and FREE for both local and national level HL7 messaging. Also, it’s currently being used by all of the government agencies including the VA, Social Security Administration and many state health departments.

CONNECT actually works hand-in-hand with NHIN and is being pushed as the NHIN’s choice messaging system/provider. It’s financially governments backed, which is actually pretty awesome considering it’s OPEN SOURCE!

Three primary elements make up the CONNECT solution:

1) The Core Services Gateway provides the ability to locate patients at other organizations, request and receive documents associated with the patient, and record these transactions for subsequent auditing by patients and others. Other features include mechanisms for authenticating network participants, formulating and evaluating authorizations for the release of medical information, and honoring consumer preferences for sharing their information. The NHIN Interface specifications are implemented within this component.

2) The Enterprise Service Components provide default implementations of many critical enterprise components required to support electronic health information exchange, including a Master Patient Index (MPI), XDS.b Document Registry and Repository, Authorization Policy Engine, Consumer Preferences Manager, HIPAA-compliant Audit Log and others. Implementers of CONNECT are free to adopt the components or use their own existing software for these purposes.

3) The Universal Client Framework contains a set of applications that can be adapted to quickly create an edge system, and be used as a reference system, and/or can be used as a test and demonstration system for the gateway solution. This makes it possible to innovate on top of the existing CONNECT platform.

Website: http://www.connectopensource.org/

-Chris
www.ehrlive.com

2

johnbwilliams wrote on Saturday, June 26, 2010:

Chris,

Please enlighten me on the connection between the year-old CONNECT verbage and my request for comment on implementing NHIN Direct use cases in OpenEMR.

John

3

anonymous wrote on Sunday, June 27, 2010:

John,

It’s my understanding that NHIN is a set of standards relating to the security of exchanging health information across the internet. That being the case if OpenEMR is to adopt NHIN standards, well it needs to have some sort of health information exchange platform and network in which to exchange the information with. That being the said, the connection with CONNECT and NHIN is very obvious, especially with my debrief on exactly what CONNECT is and can do for such an EMR software that is open source as well.

-Chris
www.ehrlive.com

4

johnbwilliams wrote on Sunday, June 27, 2010:

Chris,  this thread was about NHIN Direct phase 1 use cases in OpenEMR.   I’m trying to be polite in telling you that NHIN Exchange and CONNECT have little relevence to NHIN Direct use cases in OpenEMR.

5

drbowen wrote on Sunday, June 27, 2010:

Dear John,

You have been immersed in this area of study so deeply and for a long time.  What is obvious to you may not be so obvious to the rest of us.  Would you write a paragraph or two about the differences between NHIN CONNECT and NHIN Direct to help those of us who have not studied this area so deeply?

My understanding is that NHIN CONNECT is an application consisting of a suite of individual programs that allows connection to the National Health Information Network (NHIN) which the last time I checked only exists in the minds of our US congressmen and US President.   As a net work the only people that can talk to each other and transmit electronic protected health information (ePHI) are the Veterans Administration Hospitals, the US Department of Defense (US military hospitals) and probably CMS (Center for Medicare and Medicaid Services, yea…I know, thats 2 "M"s not one).  CONNECT was developed by Sun Microsystems and has open source licensing.  From its description it is big and complex.  That translates into expensive and difficult to establish a connection.  Also you have to be big, like the State of North Carolina or New Jersey, to establish a connection.  While the feds have a lot of resources they are not infinite and they are not going to allow me to connect from my kitchen (an Ubuntu distribution by the way).

You explained to me by email that the NHIN Direct program is an attempt to create a NHIN CONNECT “Lite.” Primarily to let smaller organizations (like ours) make connections to NHIN in a way that mere mortals can actually manage.  Is that correct?

So, we might be able to figure out how to run the Sun Microsystems CONNECT but are not likely to be allowed to connect anyway because we are too small.

You are proposing to build in the the lighter NHIN Direct protocols into OpenEMR?  Something that is much easier to manage and will actually be used by the OpenEMR end users?

Sam Bowen, MD
http://openmedsoftware.org