HHS wiki airs concerns about planned health network service

The Health and Human Services Department’s month-old wiki for its new “Nationwide Health Information Network Direct” service is publicizing the service and airing concerns that it might impinge on state health information exchanges.

The HHS Office of the National Coordinator for Health Information Technology announced the NHIN Direct service a month ago as a simplified way to conduct secure health data exchange through the Internet via the NHIN. The new service would use simplified versions of the current standards and services of the NHIN.

The NHIN Direct Web site and wiki, launched on March 1, provide an overview of the project. The wiki also provides a window into questions and concerns being raised by potential users of the system.

“This could be a huge mistake!” reads the heading of an NHIN Direct wiki discussion thread on March 5. “If this is not done correctly NHIN Direct could create significant issues with Health Information Exchanges and statewide efforts.”

What follows in that wiki discussion thread are nine comments offering additional information and points of agreement and disagreement with that view.

HHS officials have described NHIN Direct as offering basic network transport services for sharing records securely over the Internet. The overall effect on state health data exchanges is not known because those exchanges generally are in development, but an HHS advisory panel recently heard concerns that there may be negative eeffcts on state exchanges from NHIN Direct. The argument is that if NHIN Direct allows for direct health exchange, there may be less need for statewide exchanges.

According to the NHIN Direct Web site, the key deliverables of the project will be standards and service definitions, implementation guides, reference implementations, and associated testing frameworks. “The project will not run health information exchange services,” the NHIN Direct Web site states.