HHS Launches Health Information Exchange PilotsHHS Launches Health Information Exchange Pilots

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The Department of Health and Human Services' (HHS) Office of the National Coordinator for Health IT (ONC) announced Wednesday that providers and public health agencies in Minnesota and Rhode Island have begun exchanging encrypted personal health information (PHI) over the Internet as part of the Direct Project.

The Direct Project is an open government initiative that develops specifications for a secure, scalable, standards-based way to establish universal health addressing and transport for participants (including providers, laboratories, hospitals, pharmacies, and patients) to send encrypted health information directly to known recipients over the Internet.

"There are at least two things that we have to accomplish in our overall goal of modernizing the health information system in the United States. The first is to get information into electronic form. The next thing we have to do is to get that information moving. The Direct Project is a critical tool for that movement," David Blumenthal, national coordinator for health IT, said at a press briefing on Wednesday.

Blumenthal also said the two pilot demonstrations -- which will soon be followed by similar projects in New York, Connecticut, Tennessee, Oklahoma, Texas, and California -- mark an important milestone in ONC's journey to achieving a secure health information exchange (HIE) system which will provide physicians and other clinicians with added support as they work toward meeting stage 1 meaningful use requirements. Offering the Direct Project's online capabilities to clinicians "means that healthcare providers large and small will have an early option for electronic exchange of information supporting their most basic and frequently needed uses," Blumenthal said.

Since mid-January, Hennepin County Medical Center (HCMC), Minnesota's premier level 1 adult and pediatric trauma center, has been successfully sending immunization records to the Minnesota Department of Health (MDH).

"This demonstrates the success that is possible through public-private collaborations," James Golden, Minnesota's state health IT coordinator, said in a statement. "This is an important milestone for Minnesota and a key step toward the seamless electronic movement of information to improve care and public health."

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The second pilot implementation site, the Rhode Island Quality Institute (RIQI), has delivered a pilot project with two primary goals. First, RIQI is improving patient care by demonstrating simple, direct provider-to-provider data when patients are referred to specialists. Second, RIQI is leveraging Direct Project messaging as a means to securely feed clinical information, with patient consent, from practice-based electronic health records (EHRs) to the statewide HIE, Currentcare. The initiative is expected to improve quality by detecting gaps in care and making sure the full record is available to all care providers.

Laura Adams, president and CEO of RIQI, said in a statement that Direct Project has boosted the Institute's ability to meet its health IT goals. "Direct Project allows the Quality Institute to be on the cutting edge -- providing health information exchange via Currentcare, delivering the efficient rollout of technology through the Regional Extension Center, and enabling and measuring real patient-outcome improvements in our Beacon Community," Adams said. "The ability to bring together and drive consensus among a diverse set of stakeholders has been critical in the successful rollout of these innovative programs."

Designed as part of President Obama's open government initiative to drive rapid innovation, the Direct Project last year brought together some 200 participants from more than 60 companies and other organizations.

"By bringing together healthcare and IT companies, including competitors, to rapidly produce a system that supports basic clinical delivery and public health needs, we will be able to more quickly start building electronic information exchange into our healthcare system," Blumenthal said.

ONC officials noted that pilot testing of information exchange based on Direct Project specifications is being carried out on schedule this year, aiming toward formal adoption of the standards and wide availability for providers by 2012.

"This is a new approach to public sector leadership, and it works," Aneesh Chopra, U.S. chief technology officer, said in a statement. "Instead of depending on a traditional top-down approach, stakeholders worked together to develop an open, standardized platform that dramatically lowers costs and barriers to secure health information exchange. The Direct Project is a great example of how government can work as a convener to catalyze new ideas and business models through collaboration."