The Federal Health Architecture (FHA) program recently released version 2.1 of the federal "Connect" gateway – a technology framework developed within the Office of the National Coordinator for Health Information Technology (ONCHIT) that will allow participants to exchange health information along the National Health Information Network (NHIN).
With the federal Connect Gateway, anyone can "attend" – public or private organizations using commercial or open-source technology can all participate in this network. The federal Connect gateway invites all stakeholders in health information exchange to participate and contribute.
This party has an open-ended RSVP. But before you attend, there are some basics to know - what's being served, who's coming, and what to expect if you attend.
During the past several years, the Federal Health Architecture group - which represents both federal agencies and government contractors - has released several versions of the NHIN gateway, now referred to as the federal Connect gateway.
The goal is to enable federal agencies to securely exchange electronic health information with each other and other non-federal organizations over a common platform. The represents a quintessential part of achieving "meaningful use" of healthcare information, one that promotes patient-centric, coordinated care - which ultimately improves quality and reduces costs.
From a policy perspective, the Connect gateway addresses the legal framework for data sharing and the logistics surrounding interoperable services. From a technology perspective, it contains the basic services to facilitate connectivity and data sharing with and among federal agencies.
These open source services provide a common process to identify, request, retrieve and integrate health information across peers on a network. The services are also designed to work across technologies that already exist within an organization's environment, such as patient registries, document registries, document repositories and policy engines.
This framework is all about community - sharing knowledge and using standards. Connect supports HITSP and other organizations like IHE and HL7 that are advancing information exchange. Vendors are also encouraged to create adapters to these services using these standards to enable their technologies to "plug in" to the framework as many have done to date.
What's not on the menu
What's missing from the menu – missing from within the features of the Connect gateway – are specifications addressing the tuning and matching of multiple patient records, managing data quality, and building customized services.
If you want to manage data quality, set varying thresholds for data matching, or manage data beyond patients (providers, households, and organizations) and the relationship across that data, you'll need to incorporate additional products and services. Organizations will want to carefully evaluate their business and use-cases to determine the best approach to supplement the gateway with these capabilities.
Organizations that choose to adopt the gateway service open source license must also understand the risks and obligations associated with a community license versus an enterprise licenses. The software distributed by the Federal Health Architecture group is a community license; it does not include implementation services, enterprise support or a dedicated development team. Some organizations will require these services as a part of their service level agreements, so it is critical to understand what is offered and what is not.
Because of these missing pieces, some vendors will likely develop adapters to replace some of the FHA components. Clearly the market has many vendors of security software, terminology services, interface engines, patient identification solutions, registries and repositories. Look for the private sector to add to the menu as demand for enterprise-level services are identified and reach a tipping point that justifies investment.
Who has RSVP'd?
At this time, the greatest interest in the federal Connect gateway appears to be from federal and state agencies interested in sponsoring data exchange, as well as from existing Regional Health Information Organizations (RHIOs).
Some of the agencies already participating include the Social Security Administration (SSA), the Department of Health and Human Services (HHS), the Office of National Coordinator (ONC) and the Department of Veterans Affairs (VA). These agencies have contributed substantial time, talent, resources, and funding to deliver this framework and they will continue to play a major role as Connect evolves.
While these agencies have already RSVP'd, that doesn't mean they're abandoning their existing commercial vendors or projects already underway. These agencies will seek to leverage the best enterprise service components available to create a single view of patient medical information that is suitable for sharing across boundaries.
Planning To Attend
Whether or not you plan to participate in the federal Connect gateway project, make sure to keep your planner open. The FHA group will provide updates to federal Connect on a quarterly basis. In addition, production implementations of of Connect will not emerge until early 2010, as recommended by the ONC, so there will be a lot more to plan for down the line.
Most importantly, be aware of what you're getting yourself into. Understand that you need to support your organization's long-term data management needs beyond health information exchange. The federal Connect project will be a great opportunities to meet a broad range of stakeholders and participate as a community – an approach that will ultimately help our national healthcare system.
But it will continue to cost significant time and money to organize a successful party that benefits all the hosts, all the attendees, and everyone else along the way.
-- Lorraine Fernandes is vice president and healthcare industry ambassador for Initiate Systems, Inc.
