Friday, August 31, 2012

Nationwide Health Information Network Comes of Age

The Nationwide Health Information Network Exchange (NwHIN Exchange, or just Exchange) has been operating as an ONC program since 2007. For the past three years, a rapidly growing community of public and private organizations (Exchange Participants) has been routinely sharing information in production. That community now represents thousands of providers and millions of patients. Healtheway is new a non-profit, public-private partnership that will operationally support the eHealth Exchange (formerly referred to as the NwHIN Exchange).

On August 1, 2012, the Exchange Coordinating Committee appointed three representatives to serve on the Healtheway Board of Directors, including: Michael Matthews (CEO, MedVirginia), Paul Matthews (CTO, OCHIN) and Jan Root (CEO, Utah Health Information Network). These individuals, along with Healtheway’s Interim Executive Director, Mariann Yeager, will serve as the initial board of directors for the non-profit. The remaining Healtheway board seats will be filled by up to nine elected Healtheway members. The company launched its Member Program in August 2012, with elections for the member board seats expected in the Fall 2012.

"Transitioning the eHealth Exchange from a federal program initiative to a sustainable public-private endeavor marks a significant milepost for HIE in the U.S. The eHealth Exchange is demonstrating that secure, trusted and interoperable health information exchange on a nationwide scale is viable. As we look forward, we realize that success will only be possible through active collaboration with our public and private partners and with industry to shepherd nationwide HIE in the US to its full potential," said Mariann Yeager, Interim Executive Director of Healtheway.

In order to foster continued growth and advancement, there is a common goal to transition Exchange to an independently sustainable public-private partnership by October 2012. This will encompass at least 4 federal agencies (CMS, DoD, SSA, and VA) as well as 21 non-federal entities that can all share patient records for episodes of care. A year ago 500 hospitals were already connected, 30,000 clinical users, 3,000 providers, and a patient population coverage area of 65 million people, and 1 million shared records. These number have certainly continued to grow, and Healtheway will support the continued progress by supporting and enabling health information exchange that is trusted, that scales, and enhances quality of care and health outcomes by supporting comprehensive longitudinal health records.

Michael Matthews, CEO of MedVirginia, and a Healtheway board member and President said, "Will Rogers once said, even if you’re on the right track, you’ll get run over if you just stand there. We’re very proud of being on the “right track” with Exchange over the past few years. Much has been accomplished….and, there’s much left to be done. We are confident and excited about the Healtheway processes and business model to support the scalability and growth of Exchange. We are driven by the value created from the continued expansion of Exchange."


The Exchange Coordinating Committee has been working since 2009, and the primary purpose is to enhance trust relationships between participating organizations by fulfilling responsibilities described in the Data Use and Reciprocal Support Agreement (DURSA). The Coordinating Committee is the group that is managing this effort, voted on March 1, 2012 to approve a plan that maps out the strategy, sustainability model, and operational transition of NwHIN Exchange to a non-profit organization. As the planning process has unfolded, it is important to note the DURSA remains in full force and effect and the Coordinating Committee retains all authorities as specified in the DURSA. The Healtheway board will not have any oversight responsibilities with respect to Exchange, but will operate under a Master Services Agreement with the Coordinating Committee so that the Exchange trust framework remains unchanged.


There has been a Joint Exchange/EHR–HIE Interoperability Workgroup (IWG) Testing Task Group to collaborate on the development of test packets that satisfy both programs. The IWG and Exchange plan to use the work products vetted by this group for a robust conformance and interoperability testing and certification process of EHR-HIE systems. The Testing Task Group includes representatives from states, federal agencies, HIEs, health systems and vendors. In addition, ONC Authorized Testing and Certification Bodies (ATCBs) have observed and contributed as subject matter experts. The latest proposed test approaches are available here.

There are clear benefits already to NwHIN Exchange. The VA is sharing patient records among not only numerous VA hospitals but also non-military and private providers. There is also work under way to use Exchange to enable smoother transitions of care between the DoD, VA and the private counterparts that provide more than 50 percent of a military veteran’s care. At the Social Security Administration sharing data via NwHIN-Exchange has dramatically cut disability determination with 10 percent of claims filled in one to two days. Ultimately the value of this infrastructure is huge for all patients.

I am very excited about the progress made so far and look forward to the exciting new phase of the nationwide health information network Exchange. We are truly entering a new era...

1 comment:

  1. Thanks, Brian for this detailed explanation of the eHealth Exchange! It seems like it was a long process (since 2009) to properly transfer this program - but it is certainly very impressive that ONC was able to move this out of their control into a true public-private partnership.

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