The Office of the National Coordinator for Health IT has announced two recipients of cooperative grants under its Exemplar HIE Governance Program, offering a look at how the agency plans to support industry efforts in order to increase information exchange.
The New York eHealth Collaborative (NYeC) will receive $200,000 and Direct Trust will receive $280,205 over the next year to work on various health information exchange (HIE) initiatives, which include the creation of a national provider directory, interoperability standards, governance models and trust frameworks.
David Kibbe, M.D., the president and CEO of Direct Trust, which was established for participants in the federal Direct Project, said there are many hurdles that prevent providers from exchanging information with each other -- from costly and time-consuming legal issues and security gaps, to provider identity verification challenges. The funding will help the two organizations work to resolve some of these issues.
"Direct exchange is a means of inter-vendor, standards-based exchange of health information that is designed to overcome the barriers of organization and IT platforms that have significantly impeded interoperability and exchange of health information for as long as most of us have been working in this field," Kibbe said during a press conference call. "The grant is very important to that work."
We believe this will... ultimately get us to a place where we will see free exchange of records across the country.
David Whitlinger, executive director of NYeC, said his organization had seen other HIEs experiencing the same problems for years. These mainly revolve around connecting various electronic health record (EHR) systems to an HIE. NYeC has tried to solve these problems by developing technical specifications and interoperability standards, as well as a testing program that allows EHR vendors to receive a certification saying their product is interoperable with specific HIE organizations.
The grant will help NYeC continue this work, as well as study different strategies for addressing Direct messages to providers, Whitlinger said on the conference call. One method could be a federated approach where information on providers is stored in different locations, while another could involve some kind of centralized provider directory.
"We believe this will significantly help us move the national network forward both in technology and governance paradigms, and ultimately get us to a place where we will see free exchange of records across the country," Whitlinger said.
As part of reaching this goal, it will be important to simplify things for providers, Kibbe said. Doctors shouldn't have to become technical engineers or worry about how an HIE manages digital certifications or encryption policies. Both groups plan to continue to create interoperability standards that allow EHR software to plug into HIEs straight out of the box.
ONC will continue to be involved in these initiatives. Claudia Williams, director of health information exchange initiatives at the ONC, said the funding comes in the form of cooperative agreements, which are distinct from traditional grants. The terms of these cooperative agreements state that the ONC will have a seat at the table when it comes to defining the scope, goals and direction of the initiatives funded through the program. ONC officials will have weekly meetings with the grant recipients.
The work of the two recipients will also be conducted in parallel to other ONC activities. Williams said while the agency is not going to be putting out any new HIE regulations, it is currently developing a framework of principles that would essentially give the industry a model governance structure for HIE activities, without mandating any specific activities. This initiative is ongoing and Williams said more information will become available in the months ahead.