NwHIN Phase 2: Trial Implementations

• Click here to view a press release on NCHICA and the NwHIN Forum (PDF format)
• Click here to view a flyer about NCHICA and our NwHIN efforts in North Carolina (PDF format)
• Click here to view a list of our health care provider and corporate partners on the Consumer Access to Clinical Information Use Case (PDF format)
• Click here to view a webcast on NCHICA's work on NwHIN 2 (November 18, 2008)
• Click here to access the presentations from the December 15-16, 2008 NwHIN Forum
• Click here to view the Sustainability Plan submitted by NCHICA (January 9, 2009)

Use Cases

The NC HIE demonstrated the following Use Cases:

1. Consumer Access to Clinical Information

2. Electronic Health Record Lab Results Reporting

3. Authorized Release of Information to a Trusted Entity

• Click here to see a sample of the slides from the presentation at the NwHIN Forum.
• Use Case description
• Minutes from March 23, 2009 meeting with SSA.

NC HIE Participants

Participating providers included:

• Morehead Memorial Hospital & affiliated practices
• FirstHealth of the Carolinas
• Pinehurst Surgical Clinic
• Southern Pines Women's Health Center
• Carolina Neurosurgery & Spine Associates

Assisting vendors included:

• IBM (subcontractor)
• NextGen
• Allscripts
• eClinicalWorks
• Greenway
• LabCorp
• CapMed PHR

Background

The Nationwide Health Information Network (NwHIN) is a "network of networks" built out of state and regional health information exchanges (HIEs). The NwHIN Trial Implementations involve North Carolina along with eight other states and 26 federal agencies. The Trial Implementations are designed not just to test the technical connectivity of disparate HIEs, but to create the local and national policies, procedures, business cases and collaboratives required to support these exchanges.

The NwHIN Trial Implementations will leverage the work done by other HHS-supported initiatives: the Healthcare Information Technology Standards Panel (HITSP), the Certification Commission for Healthcare Information Technology (CCHIT), the Health Information Security and Privacy Collaboration (HISPC) and the National Committee on Vital and Health Statistics (NCVHS).

The benefits of participating in the NwHIN Trial Implementations include:

• Participants (and their vendors) will help establish interoperability standards for physician practice systems
• Clinical champions will have the opportunity to influence and measure tangible progress on interoperability among various applications and organizations
• Individuals will advance their own professional development and knowledge as they help advance the field of HIT for their organization and the larger NC health and care community
• Selected patients will become more actively involved via a consumer controlled, but electronically sharable, Personal Health Record
• Care delivery organizations that exchange clinical data will be viewed as leading proponents of interoperability and patient safety
• Patients, particularly those with complicated medical histories, will seek out early adopters that can easily exchange medical data across caregivers
• Communities achieving adoption of clinical interoperability will be viewed favorably and will compete successfully for clinicians, businesses and jobs
• Participation will encourage community-based investment by health care vendors (e.g., suppliers of physician practice systems and commercial labs)
• Participants may designate their representative to the NC NwHIN 2 Project Steering Committee that receives regular updates from the project manager and project subcontractors and assists with formulating major project decisions

The NHIN Health Information Exchanges (NHIEs) must include:

• Five or more competing provider organizations
• Different types of provider organizations, including independent physician practices and safety net providers
• Both inpatient and outpatient settings
• Both provider applications (EMRs) and consumer applications (PHRs)
• Applications from multiple competing vendors

The North Carolina Health Information Exchange (NC HIE)

The North Carolina Healthcare Information and Communications Alliance (NCHICA) was awarded the NHIN contract for the state of North Carolina, and is responsible for setting up the NC HIE. The NHIN Steering Committee and the NC Health Information Exchange Council provide guidance on policies and procedures. The technical architecture and project management methodology is provided by IBM under a subcontract to NCHICA, and builds upon IBM's experience with the NHIN 1: Architectural Prototype contract.

NCHICA is a nationally recognized nonprofit consortium that serves as an open, effective and neutral forum for health information technology (HIT) and policy initiatives that improve health and care in North Carolina. NCHICA's 200 members include leading organizations in healthcare, research and information technology. Working closely with its members, NCHICA has the unique ability to convene and form partnerships to advance HIT adoption. NCHICA's leadership in conducting demonstration projects, hosting educational sessions and fostering collective efforts within North Carolina helps position the state at the vanguard of national HIT acceleration efforts.

Provider Responsibility for Core Services and EHR Use Cases

• Transmit patient summary and laboratory test results - from EMR and disparate laboratory information systems to the NC HIE
• Integrate patient summaries and lab results from the NC HIE into EMR - receive summary documents and test results for integration into the clinician's EMR, or sends the content to another clinical data system for viewing
• Send user credentials - when querying for patient summary or lab results from other sources to the NC HIE
• Receive notification of availability of new lab test results - receive result location and related information by the ordering clinician and other providers of care

Core Services

Key Data Services

• Data delivery
• Summary record exchange
• Patient look-up in and between NHIEs
• Supporting access to data for secondary uses

Key User and Identity Management Services

• User identity proofing, authentication and authorization or attest for connected organizations
• Identity adjudication between NHIEs

Key Management Services

• System and trusted user protection
• Emergency access (individual and community)