Updated Connect gateway software, released March 16 by the Office of the National Coordinator for Health IT incorporates technical standards and descriptions for the nationwide health information network (NwHIN) Exchange to support functions such as patient discovery and query and retrieval of documents.
Connect gateway and adapter software uses NwHIN standards and services to enable healthcare organizations and federal agencies to share patient information securely through the Internet.
In addition to the specifications, the Connect version 3.3 is designed to improve performance and usability and prepare the gateway for higher volumes, said Lauren Thompson, director of ONC’s Federal Health Architecture.
Federally developed Connect is an open source solution that can be used to set up health information exchange within an organization or tie an exchange into a regional network of health information exchanges (HIEs) using NwHIN standards and services.
Changes in the works
The Federal Health Architecture plans this year to develop a prototype to streamline and re-architect the set of software and services under the new name of Connect+ (ConnectPlus).
“We plan to separate out the gateway from the adapter lines of code, which are fairly tightly coupled. That means it’s been difficult to implement for many organizations,” Thompson said at a March 15 conference about military electronic health records (EHRs).
Connect+ will have clearly defined interfaces and continue to use NwHIN technical specifications so it will become a portfolio for common software services to make it easier for organizations to choose and deploy what they need.
More changes are coming. By December, ONC will move Connect out of its purview to a distributed development program in an open-source community and is considering a variety of organizational approaches, including adopting a custodial agent process, similar to what the Veterans Affairs and Defense Departments use to develop their integrated EHR.
The Connect move coincides with ONC's plans to stand up the NwHIN Exchange in October as a private non-profit business organization.
The NwHIN Exchange has been an organization for advanced exchange for primarily federal agencies and large healthcare organizations because of a requirement that limited participants to federal contractors or grantees.
It has 25 partners including DOD and VA, which uses NwHIN to share information at 11 virtual lifetime electronic record (VLER) sites, and the Social Security Administration, which has 300 provider organizations exchanging data to accelerate disability determinations.
The exchange has allowed providers “to see real-time data that they might not have been otherwise able to see, leading them to different treatment options and some avoidance of allergic reactions that might have been life-threatening had the providers not had the information available,” Thompson said.
In January, the Department of Health & Human Services lifted the federal contractor condition because “rules of the road” and governance had matured through use of its legal data use and reciprocal support agreement. “Since then, we’re seeing a lot more interest from the provider community in joining the exchange,” she said.
ONC has said it will soon release a proposed rule on governance, which will enable many more providers of all sizes to participate in the NwHIN Exchange. Connect has been a critical tool and representation of the NwHIN Exchange.
Connect also incorporates the protocols for Direct exchange for one-to-one simple sharing through secure messaging. ONC is focusing on the development of certificate discovery and provider directories now and working with state HIEs to support Direct implementations.The growth of all of these exchange tools aims to drive more sharing of health information to coordinate patient care, the cornerstone of stage 2 of meaningful use of EHRs.