Yesterday marked another milestone on the Nation’s journey to better health care through the use of electronic health records and health information technology. Two pilot projects were launched—one in Minnesota and the other in Rhode Island—for easily and securely transmitting personal health information via the Internet. These efforts—combined with others that will soon be underway in Tennessee to support the Department of Veterans Affairs, and commercial providers in New York, Connecticut, Oklahoma, Texas, and California—mean a very important new tool is on schedule to enable the safe transmission of patient data over the Internet by healthcare providers, instead their having to rely on mail and fax. This is a significant step toward meeting the Administration’s commitment to make health information exchange (HIE) accessible and practical for all the Nation’s clinicians.
HIE is one of the primary benefits that can be derived from adopting health information technology. HIE means your records can be shared securely among your doctors without getting lost or delayed. It means your hospital discharge instructions can be provided instantly to your physician—and to you. It means that if you are in an accident and arrive in the emergency room unconscious, your record can be made available and the care you receive can be that much safer and more effective.
Since last year, the Department of Health and Human Services (HHS) has been supporting a new initiative, the Direct Project, to provide an early, practical option for HIE. The Direct Project aims to rapidly develop a system that providers can use to support the simpler information exchange functions they need the most.
The vision for this project came from a number of key sources, including a lively discussion of the “Health Internet” at Harvard University in September 2009; the testimony of practicing providers to the HIT Standards Committee in October 2009; and thought leadership in a series of blog posts by HIT Standards Committee members Wes Rishel and David McCallie on the strategy of “Simplified Interop," focusing on simple, internet-based methods for secure, directed communication. Their work was reviewed and endorsed by the Nationwide Health Information Network Workgroup of the HIT Policy Committee in January 2010.
On March 1st, 2010, under the direction of Farzad Mostashari and Doug Fridsma from HHS’s Office of the National Coordinator, Arien Malec kicked off the Direct Project. The fact that pilot programs have begun to launch just 10 months later means that safe, Internet-based transfers of most-used health information is on its way to becoming a reality in the United States. That will enable existing electronic exchanges to become more standardized and convenient. And it will enable many more providers, and many more data transactions, to take advantage of the HIE benefit. Already, vendors have announced support for patient access to health records based on the Direct Project, and have committed significant dollars and resources to the effort.
How was this fast-paced development achieved? We set aside the “top down” approach that’s traditional for government and adopted some lessons from the innovative IT sector. We invited private companies (including some well-known businesses that usually compete against one another!) and public sector entities to work together, on a volunteer basis, to respond to the need for a leading-edge HIE option. Here was the challenge: Create an easy-to-use tool, with uniform requirements, that will support HIE for the most common clinical information needs, all while delivering a useable result for providers, in less than two years.
And it’s working. Employing the principles and practices embodied by President Obama’s Open Government directive, these different stakeholders worked together and delivered a product, which is now in its testing phase. These same stakeholders are now encouraged to develop competing products based on the very standards they worked together to assemble!
It’s time for new ways of achieving the public good. The growing national commitment to harnessing health information technology is one way to further this good. And the open government approach that so efficiently delivered an entry-level HIE system, ahead of schedule, is yet another. The launches of these newest pilot projects are milestones worth celebrating.
Aneesh Chopra is U.S. Chief Technology Officer
Dr. Blumenthal is National Coordinator for Health Information Technology