Nationwide HIE Corrals 500 Hospitals, 4,000 PracticesNationwide HIE Corrals 500 Hospitals, 4,000 Practices

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More than 500 hospitals and 4,000 physician practices and clinics are participating in the Nationwide Health Information Network (NwHIN) exchange, according to Lauren Thompson, program director of the Federal Health Architecture (FHA) program in the Office of the National Coordinator for Health Information Technology (ONC).

In an exclusive interview with information Healthcare, Thompson noted that most of those hospitals are involved in one of two government programs. First, the Virtual Electronic Lifetime Record (VLER) program of the Department of Defense (DoD) and the Department of Veterans Affairs (VA) has launched a pilot at 11 VA medical centers across the country. In that test, the two departments' health facilities are using the NwHIN exchange to connect to each other and to private healthcare providers that treat military personnel and veterans. That program includes the majority of hospitals on the NwHIN exchange, Thompson said.

Fewer hospitals, she noted, are engaged in a Social Security Administration (SSA) program that uses the NwHIN exchange to expedite the determination of eligibility for disability benefits. As part of this process, providers must review applicants' medical records and then send this information to the SSA. The department has found that using the NwHIN exchange speeds up this process by 45 percent, according to Thompson.

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Bon Secours Richmond Healthcare System in Richmond, Va., is using the NwHIN exchange not only to transmit disability data to SSA, noted Thompson, but also to get expedited determination of health benefits coverage from the Medicare and Medicaid programs. Bon Secours has seen revenue enhancement as a result, she added.

Some community and state health information exchanges have also connected with the NwHIN exchange, the FHA chief pointed out. These HIEs, like other providers on the NwHIN exchange, can communicate with any other provider that has exchange privileges, not just federal agencies. Thompson said some private-sector providers are trading information with each other through the NwHIN.

Just as many electronic health record vendors have embedded the Direct secure messaging protocol into their applications, some have also added the ability to connect to the NwHIN. "We have 16 or 18 technology partners participating in the exchange," Thompson said.

However, not all of these use the FHA's CONNECT gateway to link to the NwHIN exchange; some have developed their own interfaces. FHA created the CONNECT gateway in 2008-2009 and is continuing to refine it through a private contractor. But Thompson noted that her office would like to encourage more participation by the open-source community in upgrading the CONNECT code. There has been discussion at FHA about appointing a custodial agent to take charge of making the code available to the community.

Meanwhile, a bigger change is in the offing. ONC plans to turn the NwHIN exchange over to a yet-to-be-established nonprofit organization that will charge participation fees and possible other service fees. Thompson said the agency hopes to complete this process by next September.

The goal of the transition is to encourage greater private-sector participation in the exchange, which is envisioned as eventually becoming a "network of networks," she said.

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