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Nationwide Health Information Network

Overview#

Nationwide Health Information Network (NHIN) is a program under the Office of the National Coordinator for Health Information Technology (ONC), was established in 2004 to improve the quality and efficiency of healthcare by establishing a mechanism for nationwide health information exchange.

Nationwide Health Information Network is a set of conventions that provide the foundation for the secure Health Information Exchange that supports meaningful use. The foundation includes technical, policy, data use and service level agreements and other requirements that enable data exchange, whether between two different organizations across the street or across the country.

Nationwide Health Information Network Participants agree to support a common set of web services and data content (NHIN Core Services) that enables private, secure and interoperable communication of health information among NHIN participants across the public Internet.

A critical component of the NHIN is the trust model that bridges a diverse group of public and private entities. This trust model provides a common foundation for privacy and security obligations, accountability and governance in the midst of varying diverse federal, state and local policies and laws. One of the significant results of this work is the Data Use and Reciprocal Support Agreement (DURSA) that is now in federal clearance. The combination of a Trust Model, technical services, and validation process for members enables health information to be securely exchanged.

There are currently 24 public and private entities participating in the NHIN Cooperative. Twenty-two Cooperative members, including seven federal agencies using the CONNECT gateway, participated in testing and demonstrations in 2008. (CONNECT is an FHA initiative to develop a federal software solution to link federal systems to the NHIN.) The CONNECT gateway has instantiated the NHIN standards and policies, using open source, to support federal agencies under the Federal Health Architecture (FHA) program.

As of February 2009, the Social Security Administration and MedVirginia were the first organizations to share live data as NHIN pilot partners. The United States Department of Veterans Affairs, the United States Department of Defense and Kaiser Permanente also expect to begin pilot demonstrations later this year. These pilot demonstrations will include onboarding the partners into the NHIN trusted community.

Moving forward, ONC will maintain overall responsibility for the governance of the NHIN, the development and management of the foundation and the demonstration of new components of the foundation. ONC will work with other federal and private stakeholders in the NHIN to realize its potential. Ultimately, the NHIN will need to be a public-private partnership, but one that is primarily managed in the private sector and self-sufficient.

Members of the NHIN Cooperative plan to use the NHIN to support secure health information exchange at national, state and local levels. To make this possible, ONC is coordinating standards development for the NHIN and the interoperability functions that are a key component of meaningful use. In this way, the NHIN will provide a path to meaningful use.

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