Health Data Crosses State Lines

The goal of a national, secure, interoperable network of health information remains elusive, but strides are being made in the form of small gains in interstate health information exchange (HIE).

In what might be a first, three state health information organizations, namely Missouri Health Connection (MHC), the Nebraska Health Information Initiative (NeHII) and the Kansas Health Information Network (KHIN), have connected to each other's networks and are able to exchange secure messages following the Direct Project protocol. Federal officials have been pushing Direct, a standards-based method of sending authenticated, encrypted health data over the Internet to known, trusted recipients.

The three organizations tested interoperability last week with dummy data following the Direct protocol, which each offers to its members, Mindy Mazur, chief operating officer of MHC told InformationWeek Healthcare. "It's one of our services, and it's obviously a priority at a national level," Mazur said.

[ What is the future of a countrywide HIE? Read National Health Information Exchange: Why The Delay? ]

Messages sent according to the Direct specification are authenticated and encrypted. "It really streamlines the process," Mazur said.

Missouri Health Connection president and CEO Mary Kasal approached the organizations in Kansas and Nebraska. "Our president just got on the phone and said let's make this happen," Mazur said. "We all decided to make this happen."

The three-state test represents the second interstate agreement for MHC. On Jan. 3, the Columbia, Mo.-based organization announced that it had successfully exchanged test messages following Direct specifications with the Illinois Health Information Exchange.

"We want to connect with all of Missouri's border states and with RHIOs," Mazur said, using the acronym for regional health information organizations. Centrally located Missouri touches eight other states, more than any other state in the country.

Although last week's demonstration was with test data, Mazur said MHC has opened up more than 300 mailboxes to date and has signed on three of the largest health systems in the state: BJC HealthCare, Mercy, and SSM Health Care. Together, they manage more than 60 hospitals across the Midwest and provide nearly 40% of all in-patient care in Missouri. Other participants include a mental health system, a rural health clinic, and MO HealthNet, the state's Medicaid program.

The Direct service allows attachments to messages, so the three state HIEs expect to be transmitting lab and radiology results soon, Mazur said. "We plan to connect the HISPs in the future," she added. HISP, or health information service provider, is a Direct Project term describing both the management of security and transport of data and an organization that sends and receives health data on behalf of a health care entity or individual, according to the Direct Project wiki.

The real goal, however, is to break down competitive barriers between healthcare providers and health IT vendors that have stood in the way of the free flow of data. This "cooperative spirit" helps enable better care, according to Mazur.

"We will continue to make it vendor agnostic," Mazur said. "Our vision is for the [health information organizations] and not the vendors to be in control of the information exchange."

Clinical, patient engagement, and consumer apps promise to re-energize healthcare. Also in the new, all-digital Mobile Power issue of InformationWeek Healthcare: Comparative effectiveness research taps the IT toolbox to compare treatments to determine which ones are most effective. (Free registration required.)