Nationwide Health Information Network (NHIN) Direct aims to develop interoperability specs, but not to replace statewide and regional health information exchanges.
"There are all kinds of exchange," Fridsma said. The federal government and its various healthcare industry stakeholders are continuing work developing the broader set of standards, services, and policies that will enable secure health information exchange over the Internet for more complex data sharing.
Right now there are about 20 participants -- including representatives from e-medical record vendors, state health information exchanges, large integrated health delivery networks, and participants in larger NHIN projects -- working on the development of interoperability specifications for NHIN Direct, Fridsma said.
The ONC's NHIN Direct wiki discussion is an opportunity for individuals to offer up comments and feedback as part of the Obama administration's "open government" initiative for transparency and collaboration with the public.
"That's the way we do our business at the ONC," Fridsma said. The goal is to have a draft of NHIN Direct specifications ready "in one or two months," he added.
While the specifications for NHIN Direct aims to address the simple, secure data exchange between healthcare providers, the effort doesn't replace the larger vision of the federal government's more comprehensive, nationwide health information network, nor the evolution of state and regional health information exchanges, he said.
"It's not an either or," he said. "NHIN Direct will solve one part of the puzzle -- secure routing of information between providers and labs, or doctors and an ER department," he said.
However, the grander vision for NHIN -- and state and regional information exchanges that will interoperate with NHIN--is to help facilitate the exchange of data for quality metrics reporting, public health reporting, coordination of care for chronically ill patients, and even nationwide queries by ER doctors treating unconscious patients.
It would be "increasingly challenging to use a simpler NHIN Direct" for those kinds of more robust, complex information exchanges, Fridsma said.