ONC announces launch of “Direct Project” pilots via Press Release and Blumenthal/Chopra Blog Post

‘Open Government’ process yields rapid drive toward early exchange of electronic health information
HHS Press Release: 2/2/2011

Blumenthal and Chopra Blog post from ONC’s Health IT Buzz blog comes after press release
Additional articles: NY Times, Govt Health IT, and Project Direct blog



The Office of the National Coordinator for Health IT (ONC) announced today that providers and public health agencies in Minnesota and Rhode Island began this month exchanging health information using specifications developed by the Direct Project, an ‘open government’ initiative that calls on cooperative efforts by organizations in the health care and information technology sectors.  Other Direct Project pilot programs will also be launched soon in New York, Connecticut, Tennessee, Texas, Oklahoma and California to demonstrate the effectiveness of the streamlined Direct Project approach, which supports information exchange for core elements of patient care and public health reporting.

The launch of the pilot demonstrations, less than a year from the inception of the Direct Project, shows the project is on track to give U.S. health care providers early access to an easy-to-use, internet-based tool that can replace mail and fax transmissions of patient data with secure and efficient electronic health information exchange.

“This is an important milestone in our journey to achieve secure health information exchange, and it means that health care providers large and small will have an early option for electronic exchange of information supporting their most basic and frequently-needed uses,” said Dr. David Blumenthal, national coordinator for health information technology.  “Other efforts are also going forward at full-throttle to build a comprehensive structure of health information exchange.  But by bringing together health care and IT companies, including competitors, to rapidly produce a system that supports basic clinical delivery and public health needs, we will be able to more quickly start building electronic information exchange into our health care system.”

Designed as part of President Obama’s ‘open government’ initiative to drive rapid innovation, the Direct Project last year brought together some 200 participants from more than 60 companies and other organizations.  The volunteers worked together to assemble consensus standards that support secure exchange of basic clinical information and public health data.  Now, pilot testing of information exchange based on Direct Project specifications is being carried out on schedule this year, aiming toward formal adoption of the standards and wide availability for providers by 2012.

“This is a new approach to public sector leadership, and it works,” said Aneesh Chopra, the United States Chief Technology Officer.  “Instead of depending on a traditional top-down approach, stakeholders worked together to develop an open, standardized platform that dramatically lowers costs and barriers to secure health information exchange. The Direct Project is a great example of how government can work as a convener to catalyze new ideas and business models through collaboration.”

The two pilot programs that have already begun using Direct Project-based information exchange are in Minnesota and Rhode Island:

Since mid-January, Hennepin County Medical Center (HCMC), Minnesota’s premier Level 1 Adult and Pediatric Trauma Center, has been successfully sending immunization records to the Minnesota Department of Health (MDH). “This demonstrates the success that is possible through public-private collaborations,” said James Golden, PhD, Minnesota’s state HIT coordinator. “This is an important milestone for Minnesota and a key step toward the seamless electronic movement of information to improve care and public health.”

Recognizing Minnesota’s leadership in delivering high-quality, cost-effective healthcare, U.S. Senator Amy Klobuchar (D-MN) said, “this is the type of innovation that can help strengthen our health care system by reducing waste and improving quality. We need to continue to improve our health care system by continuing to integrate information technology to better serve patients and providers.”

The second pilot implementation site, The Rhode Island Quality Institute (RIQI), has delivered a pilot project with two primary goals. First, RIQI is improving patient care when patients are referred to specialists by demonstrating simple, direct provider-to-provider data. Second, RIQI is leveraging Direct Project messaging as a means to securely feed clinical information, with patient consent from practice-based EHRs to the state-wide HIE, currentcare, to improve quality by detecting gaps in care and making sure the full record is available to all care providers.

Discussing RIQI’s collaborative approach to health IT, Laura Adams, president and CEO of RIQI said, “All too often, providers do not have the data they need to take the best care of patients they serve. Direct Project allows the Quality Institute to be on the cutting edge – providing health information exchange via currentcare, delivering the efficient rollout of technology through the Regional Extension Center, and enabling and measuring real patient outcome improvements in our Beacon Community. The ability to bring together and drive consensus among a diverse set of stakeholders has been critical in the successful rollout of these innovative programs.”

“Rhode Island continues to be a nationwide leader in improving health care with better information technology,” said Senator Sheldon Whitehouse (D-RI). “Health care providers communicating with each other in a secure and cost-efficient way helps patients get better sooner with less hassle and confusion.”

Other pilot projects to be launched this year include a Tennessee effort with the Veteran’s Administration, local hospitals and CareSpark to provide care to veterans and their families; a New York effort including clinicians in hospital and ambulatory care settings with MedAllies and EHR vendors; a Connecticut effort involving patients, hospitals, ambulatory care settings and a Federally Qualified Health Center with Medical Professional Services, a PHR, and a major reference laboratory; an expansion of the VisionShare immunization data pilot to Oklahoma; a California rural care effort involving patients, hospitals and ambulatory care settings with Redwood MedNet; and an effort in South Texas with a collaboration of hospitals, ambulatory care settings, public health, and community health organizations to improve care to mothers with gestational diabetes and their newborns.

The Direct Project was launched in March 2010 as a part of the Nationwide Health Information Network, to specify a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet in support of Stage 1 Meaningful Use requirements.  Participants include EHR and PHR vendors, medical organizations, systems integrators, integrated delivery networks, federal organizations, state and regional health information organizations, organizations that provide health information exchange capabilities, and health information technology consultants.

Information transfers supported by Direct Project specifications address core needs, including standardized exchange of laboratory results; physician-to-physician transfers of summary patient records; transmission of data from physicians to hospitals for patient admission; transmission of hospital discharge data back to physicians; and transmission of information to public health agencies.  In addition to representing most-needed information transfers for clinicians and hospitals, these information exchange capabilities will also support providers in meeting “meaningful use” objectives established last year by HHS, and will thus support providers in qualifying for Medicare and Medicaid incentive payments in their use of electronic health records.  The Direct Project specifications can also support physician-to-patient information transfers, and Microsoft Corp. today announced an application for that purpose based on Direct Project standards. For more information about the Direct Project, please visit http://directproject.org.

Other ongoing efforts supported by ONC are underway to bring about a comprehensive health information structure in the U.S.  These include technical and governance issues that are being addressed under the Nationwide Health Information Network, which embodies the standards, services and policies that enable health information exchange over the internet.  The Nationwide Health Information Network Exchange is already supporting some health information exchange between federal agencies and the private sector.  In addition, ONC provides grants to states to develop locally-appropriate policies and standards for health information exchange that are consonant with broader national standards.

For more information about the Office of the National Coordinator for Health Information Technology, please visit http://healthit.hhs.gov/.

Direct Project Pilot Programs Launched
Wednesday, February 2nd, 2011 | Posted by: Dr. David Blumenthal and Aneesh Chopra U.S. Chief Technology Officer and Associate Director for Technology White House Office of Science and Technology Policy on ONC’s Health IT Buzz blog and reposted here by e-Healthcare Marketing.

Today we celebrated another milestone on the Nation’s journey to better health care through the use of electronic health records and health information technology. We launched two pilot projects – one in Minnesota and the other in Rhode Island – for easily and securely transmitting personal health information via the Internet. These efforts – combined with others that will soon be underway in New York, Connecticut, Tennessee, Oklahoma, Texas, and California – mean we’re on schedule with a very important new tool that will soon enable health care providers to safely transmit patient data over the Internet, instead of relying on mail and fax. This is a significant step toward meeting ONC’s commitment to make health information exchange (HIE) accessible and practical for all the nation’s clinicians.

HIE is one of the primary benefits that can be derived from adopting health information technology. HIE means your records can be shared among your doctors, without getting lost or delayed. It means your hospital discharge instructions can be provided instantly to your physician – and to you. It means that if you are in an accident and arrive in the ER unconscious, your record can be made available, and the care you receive can be that much safer and more effective.

Since last year, HHS has been supporting a new initiative, the Direct Project, to provide an early, practical option for health information exchange. Even while other work goes on to build a more complete HIE infrastructure, Direct aimed at rapidly developing a system that providers could use soon, to support the simpler information exchange functions that they need the most.

This project started only 10 months ago, in March 2010. Now, the launch of pilot programs means that we’re on schedule to take it live, and make safe, Internet-based transfers of most-used health information a reality in the United States. That will enable existing electronic exchanges to become more standardized and convenient. And it will enable many more providers, and many more data transactions, to take advantage of the HIE benefit.

How was this fast-paced development achieved? Actually, by adopting some lessons from the IT sector itself. We set aside the “top down” approach that’s traditional for government. Instead we invited private companies (including some well-known competitors!) and public sector entities to work together, on a volunteer basis, to respond to the need for a leading-edge HIE option. Here was the challenge: Give us an easy-to-use tool, with consensus specifications, that will support HIE for the most common clinical information needs – and deliver a useable result for providers in less than two years.

And it’s working. Employing the principles and practice of “open government,” as championed by the President, these different stakeholders worked together and delivered a product, which is now in its testing phase. These same stakeholders will go out, we hope, and develop competing products based on the very standards they worked together to assemble!

It’s time for new ways of achieving the public good. The national push to health information technology is one new horizon. And the “open government” principles that today are delivering an entry-level HIE system, ahead of schedule, are yet another.

It is indeed a milestone worth celebrating.
For comments on Blumenthal/Chopra blog post, go directly to ONC’s Health IT Buzz blog.

Press Roundup
Steve Lohr of New York Times describes in February 2, 2011 Bits blog post how ONC took a  “page from the open-source model of collaboration” to develop the Direct Project, formerly called NHIN Direct.

In Government Health IT on February 2, 2011, Mary Mosquera reported that a  “total of 29 health IT vendors say they plan to connect using Direct’s standards and specifications.”

Arien Malec, director for the Direct Project, wrote his own blog post with initial reporting on the breadth of the project and a go-live event held in Washington, DC on February 2, 2011.

Peter Neupert, corporate vice president of the Microsoft Health Solutions Group, announced in his Neupert on Health blog on February 2, 2011 ”that next week we will be launching new functionality that wires every Microsoft HealthVault account to use online encrypted patient e-mail based on Direct Project security protocols. To start with, we will enable physicians to transmit a copy of a patient’s clinical information to a new email address created within HealthVault.”

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