Surescripts announced yesterday it would expand its electronic prescribing network to offer health information exchange services for all types of clinical information, including the basic health record sharing envisioned under the federal Nationwide Health Information-Direct project.

In doing so, the e-prescribing company has positioned itself to offer a solution to "the last mile" problem of connectivity with small practices, according to a health IT expert.

NHIN Direct, a streamlined version of standards being developed for nationwide health information exchange, is aimed at equipping small health care providers with tools for qualifying for the first stage of the meaningful use incentive plan, which requires providers to be capable of exchanging basic clinical summary data securely.

At an Oct. 25 breifing, Surescripts president and CEO Harry Totonis said the Surescripts network will let current electronic health record systems (EHRs), health system networks and smaller exchanges connect to its national backbone, which, in turn, can connect them with any other network. The e-prescriber already connects healthcare providers with retail pharmacies and pharmacy benefit managers.

"The services will be new, but the approach will not," said Totonis. "Our network will be open and neutral, and we see it as complementary to other healthcare networks and to local exchanges." Electronic prescribing adoption has grown to 200,000 physicians within the decade using those open principles.

Surescripts will provide technical tools for participants to be able to access exchange services through Kryptiq, a technology partner that supplies open and collaborative messaging connectivity.

Secure routing and messaging is the foundation for NHIN Direct, a project of the Office of the National Coordinator for Health IT (ONC).

Dr. John Halamka, chief information officer of Harvard Medical School and Beth Israel Deaconess Medical Center, said that health information exchange allows physicians to coordinate care and improve quality, safety and efficiency. Halamka is also co-chair of the Health IT Standards Committee, which advises ONC.

"Surescripts is accelerating connectivity by leveraging its existing e-prescribing network to provide novel data exchanges among providers," he said during a panel in support of the announcement. "This is really going to accelerate our work to get at the last mile, especially to small provider offices," he said.

For example, the New England Healthcare Exchange Network (NEHEN), which Halamka chairs, connects 10,000 providers in Massachusetts for e-prescribing, summary of care and other transactions. But another 10,000 physicians, mostly in solo and small practices, are not connected to NEHEN.

However, "virtually all of the unconnected providers have e-prescribing capabilities and great adoption of the Surescripts network throughout the state," he said.

If NEHEN could use the existing connectivity of the e-prescribing network to go to the health information exchange backbone in the state, "we would suddenly accomplish our vision with every provider connected to every provider," Halamka said.

The effort to get information with clinical relevance from one physician to another is critical, practical and will have almost immediate results, said Dr. David Kibbe, a consultant for the American Academy of Family Physicians. The idea of using what is basically secure email and then building services on top of that "is a big deal. It's so simple and so elementary," he said at the briefing.