Section 4.11 Implement

Section 4 Implement—Using CONNECT for HIE - 1

Using CONNECT for HIE

Prepare to participate in a health information exchange organization (HIO) that utilizes the CONNECT protocol for exchanging health information.

Time needed: 2 hours
Suggested prior tools: NA

How to Use

  1. Appreciate that more sophisticated exchanges of health information can occur using a HIO that follows the federally-approved CONNECT protocol.
  2. Learn how to participate in an HIO and use CONNECT.

What is CONNECT?

CONNECT is a free, open source software that organizations can use to securely link their existing health information technology (HIT) systems into health information exchanges. (While the software is free, there are costs associated with implementing and maintaining the solution—which typically are passed on to users in the form of transaction fees or other charges.) The CONNECT solution enables secure and interoperable electronic health information exchange with other standards-compliant organizations, including federal agencies, state, tribal and local-level health organizations, and private sector health care organizations. CONNECT acts as a gateway to the nationwide network by using standards and governance to ensure the information exchanged is compatible with other CONNECT sites or “nodes.”

CONNECT can be used to:

·  Set up a health information exchange (HIE) within an organization, such as a corporation of skilled nursing facilities.

·  Tie an organization into regional and national networks of health information exchanges using federally-approved standards. (This could connect your organization to the federal agencies part of the network exchange, or with a different network.)

What is the Nationwide Health Information Network (eHealth Exchange)?

The nationwide health information network (NwHIN), now called the eHealth Exchange, is a set of standards, services and policies that enable the secure exchange of health information over the Internet. Along with more than 20 federal agencies, the Office of the National Coordinator (ONC) began developing the NwHIN in 2004. It has continued to evolve to meet changing needs and environments. Specific projects and outcomes of the eHealth Exchange include CONNECT and the Direct Project (see Section 4.10 Using Direct for HIE), which is a secure, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet.

The eHealth Exchange is not a physical network that runs on servers at the U.S. Department of Health & Human Services, nor is it a large network that stores patient records.

The standards, services, and policies of the eHealth Exchange are intended to help move health care from a system where patient information is stored in paper medical records and carried from one provider to another to one that stores and shares information securely and electronically. The vision is for health information to follow the patient and be available for clinical decision making and tasks such as measuring quality of care.

How is CONNECT Different than Direct?

CONNECT supports query exchange (see Section 1.8 HIE Technology Readiness Inventory ) and Direct does not. CONNECT supports the exchange of larger volumes of data, such as large files of aggregated data. It has more comprehensive event and audit logging and supports multiple different platforms on which to run the software. It also uses more sophisticated security structures, while still maintaining the basic requirements of Direct’s transport and messaging standards.

Because of its ability to connect to the eHealth Exchange, CONNECT also maintains a more robust “trust fabric.” This includes operating procedures, a data use and reciprocal sharing agreement (DURSA) , and the eHealth Exchange service interface specifications. Each state-certified HIO may have its own unique version of the federal DURSA, as well as specific standards to support interoperability in that state. For example, the Minnesota Department of Health provides guidance on Standards Recommended to Achieve Interoperability in Minnesota at: http://www.health.state.mn.us/e-health/summit/g2standards2009.pdf.

Getting Started in an HIO with CONNECT

Most home health agencies will perform health information exchange either using Direct or via participation in an HIO:

  1. Determine what HIO options there are in your state. The State Health Information Exchange Cooperative Agreement Program is a federal-state collaboration with a long-term goal of ensuring nationwide HIE and interoperability. It maintains a directory of key contacts in each state that can be accessed at: http://statehieresources.org/contacts/.
  2. Contact your EHR or other HIT vendor to determine its capabilities to connect to the eHealth Exchange.
  3. Compare costs and benefits of using Direct with CONNECT. These costs and benefits may include consideration for using the Centers for Medicare & Medicaid Services’ (CMS) esMD (electronic submission of medical documentation) process. Although primarily used today for submitting electronic copies of EHRs to recovery audit contractor (RAC) auditors, it is likely that more uses will be found for esMD over time.

Copyright © 2014 Updated 03-19-2014

Section 4 Implement—Using CONNECT for HIE - 2