A panel that advises the Office of the National Coordinator for Health IT has endorsed steps to help healthcare providers identify and address hospitals, clinics, labs and other organizations electronically through directories.

The Health IT Policy Committee also approved broad recommendations for rules of the road for governing the Nationwide Health Information Network in order to draw more participants. The NHIN is a set of standards and services that enables mostly large providers to share patient data securely through the Internet.

The two sets of recommendations act as building blocks for health information exchange to coordinate and improve the quality of patient care, members of the policy committee said at its Dec. 13 meeting.

The committee’s information exchange work group described the features and policies for starting up entity-level provider directories to support health information exchange for meaningful use of electronic health records starting in 2011, said Mickey Tripathi, panel chair and CEO of the Massachusetts eHealth Collaborative.

Healthcare organization directories will smooth information exchanges where the sender and receiver generally are known to each other. They will also offer relevant electronic data about the organization, its exchange capabilities and security credentials.

The directories will contain only identification information, like name and address and contacts, or link to it at the organization’s website, Tripathi said.

“Verifying provider organizations in directories will be part of other security processes, like certificate issuance,” he said.

Directories will operate in an Internet-like model, with certified registrars that accept organizations based on national guidelines. Each registrar will publish directory information into a national provider directory registry system.

According to the recommendations, the Health and Human Services Department should “use the strongest available levers to require registration and encourage” the use of the nationwide provider organization directory and should incorporate it into meaningful use requirements in 2011 or 2013, Tripathi said.

State health information exchanges and “beacon” model health IT communities should also use the provider directory system. The advisory Health IT Standards Committee will identify the technology, vocabulary and content standards to create a provider directory with multiple registrars and the single registry, he said.

Tripathi anticipates that innovation will likely follow the creation of directories, although organizational directories will have value in and of themselves as they ramp up.

“Once you start to create a basis for information that you have not had before, you don’t know what others will be able to do with this information,” he said.

The work group will next develop proposals for individual provider directories.

The policy committee also endorsed recommendations for the foundation of NHIN governance, which includes rules of behavior and technical operations that will also assure patients of the privacy and security of their health information.

The NHIN will be the preferred approach for nationwide exchange, and ONC will back up that preference with “strong incentives to vigorously promote adoption,” said John Lumpkin, MD, the work group chair. He is also director of the Robert Wood Johnson Foundation’s health care group.

ONC should also establish conditions for interoperability and trust to earn the confidence of healthcare providers and consumers so the health care community will expand use of the NHIN. These include fair information practices and consent to assure privacy, technical requirements for secure transport and a level of conformance for interoperability, he said.

At the same time, certification of electronic health records will also include those conditions of trust and interoperability that rely on the functionality of the health IT technology, Lumpkin said. ONC should oversee NHIN governance.