Building blocks

The national network is working on amenu of seven core services, including theelectronic exchange of patient lab results,medication histories and basic patient registryinformation that physicians typicallyrequest. "The idea is not to have to fill outthe dreaded clipboard so many times,"Loonsk said.The goal is to make the information moreportable so that a patient from, for example,California who gets injured in New York doesnot have to rely on numerous calls to his orher primary-care doctor at home to get basicmedical information. If the patient is broughtto a New York hospital unconscious from anaccident, the need for prescription druginformation and medical history is urgent.Even so, the challenges are daunting asmost patients, physicians and medical institutionswant to maintain strict control of theinformation. "In my view, we cannot begin tobuild and operate the technology without anunderlying foundation of how to protect theinformation," said Holt Anderson, executivedirector at the North Carolina HealthcareInformation and Communications Alliance,which operates one of the nine regionalexchanges.In North Carolina, officials are startingmodestly with an initial focus on electronicexchanges of recent drug prescriptions andrecent lab results for specific patients ratherthan a full medical history. It will enablecaregivers in Charlotte, for example, toreceive background information on recentdrugs taken by a patient visiting fromAsheville. "Eventually, we will want a completepicture, but right now, 85 percent ofthat information is resident in physicians'offices," Anderson said.In other states, officials are also working onsharing additional types of clinical information,providing situational awareness for publichealth, and reconciling information onsuch items as medication.So far, the hospital and health care systemsseem willing to pay part of the tab. For example,the California Regional HealthInformation Organization in San Franciscoannounced in May its intention to build thecountry's largest statewide health informationexchange utility. It did not receive anHHS contract in the latest round of fundingfor the national network but intends to jointhe national network eventually.The organization is touting a goal ofreducing an estimated 50,000 instances ofmedical errors and suboptimal care occurringper day in the state because of missinginformation. It wants to offer communitiesan alternative to building and financing theirown infrastructures.However, the federal approach is toexpect that regional health systems will gainbenefits from the electronic exchanges andwill be willing to provide the primary fundingfor the networks, Loonsk said. "We aresticking to making the nationwide networkself-sustaining."

Officials responsible for constructing the
Nationwide Health Information Network
are relying on numerous information technology
contractors for assistance as they
embark this month on an initiative to connect
regional health information exchanges.

Contractor support is expected to expand
further in the next several years as federal
and state officials strive to link the nine
regional information exchanges, federal and
industry officials said. The initiative eventually
will involve all 50 states.

"The Nationwide Health Information
Network will be a secure network: a network
of networks," said John Loonsk, director of
interoperability and standards at the Health
and Human Services Department's Office of
the National Coordinator of Health
Information Technology, which is overseeing
development of the network. He said
that federal officials hope to show how the
regional networks can link to one another by
September 2008.

The national network has been in the
planning and demonstration phase for at
least three years and is expected to provide a
foundation for electronic medical records by
2014. Some basic hurdles remain to be overcome.

For example, it is not yet clear
whether patients and physicians will accept
electronic records as sufficiently private and
accurate. More than 80 percent of medical
records are on paper.

Officials also need to standardize formats
and terminology for the exchanges. And
some technology issues are still being debated,
such as which information should reside
in a secure network and which should be
stored on a computer chip or card carried by
the patient.

Burst of activity

But a flurry of activity and contracts in
recent months suggests that the national
network idea is gaining traction. HHS
Secretary Mike Leavitt announced contracts
Oct. 5 totaling $22.5 million to nine
health information exchanges in California,
Delaware, Indiana, New Mexico, New York,
North Carolina, Tennessee, Virginia and
West Virginia. Those exchanges will
begin operating and linking with one
another in a nationwide network.
The major IT contractors supporting
those efforts include:

  • CGI of Fairfax, Va.,announced Oct.
    24 that it has been selected as the
    lead systems integrator for connecting
    CareSpark's regional
    health information network in
    Tennessee and Virginia with the
    national network.

  • Computer Sciences Corp. announced Oct. 15 it is supporting
    the New York eHealth
    Collaborative for the implementation
    of the national network.
    CSC estimates the value of the
    contract, which has a one-year base
    and two one-year options, to be
    $3.5 million if all options are exercised.

  • IBM Corp. said earlier this year that it had developed a standards-based
    system based on
    a service-oriented
    architecture to connect
    information
    exchanges for the
    national network.
    IBM has installed and
    operated the solution at
    the Duke University
    Health System and six
    other hospitals as part of
    the North Carolina
    Healthcare Information and
    Communications Alliance.

    IBM said it had used
    open-source software from
    openEMR.org and products
    from subcontractors Allscripts
    LLC, of Chicago; BioImaging
    Technologies Inc., of Newtown,
    Pa.; GE Healthcare, of the United
    Kingdom; Healthvision Inc., of
    Irving, Texas; Initiate Systems Inc.,
    of Chicago; McKesson Corp., of San
    Francisco; MediTech Inc., of Westwood,
    Mass.; and SureScript Systems Inc., of
    Alexandria, Va.

  • Medicity Inc.
  • of Salt Lake City and Perot
    Systems Corp.
    teamed on a contract to create
    the Delaware Health Information
    Network as part of the national network.
    The first phase of the project involves
    three hospitals, several physician offices
    and a clinical laboratory network. The
    companies also are working together,
    along with Hewlett-Packard Co., to create
    a health information exchange in San
    Francisco that is not yet part of the
    national network.

Multiple challenges remain














































































Staff writer Alice Lipowicz can be reached at
alipowicz@1105govinfo.com.
X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.