1. NHIN Direct Project Communications Work Group Message for State HIE/RECs August 30, 2010

2. What is the NHIN Direct Project? A project to create the set of standards and services that with a policy framework enable simple, directed, routed, scalable transport over the Internet to be used for secure and meaningful exchange between known participants in support of meaningful use 2 NHIN Direct

3. Implications of NHIN Direct for State HIE »Many states are planning more comprehensive interoperability solutions Governance and Business Agreements Translation and transformation services Patient and document discovery Aggregation of information Quality measurement Public health reporting »And also secure routing »NHIN Direct may help support comprehensive state-level interoperability by helping fill the gaps in coverage »The commoditization of secure routing through NHIN Direct does not necessarily threaten existence/ business case of comprehensive state HIE efforts

4. Potential Role of States in Enabling Secure Routing Through NHIN Direct »Clarifying any state-level privacy and security requirements for secure routing of patient information for treatment purposes »Providing authoritative directory services (provider, plan, pharmacy) »Participating in NHIN Direct (Medicaid, Public Health,) »Promoting NHIN Direct-mediated information exchange at the state level »Enabling organization providing identity management and authentication services »As Accreditation or Certification body for enabling organizations »Participating in implementation geographies and pilot projects

5. Implications of NHIN Direct for RECs »NHIN Direct will help meet several of the Meaningful Use objectives »Affordable option for small practices and CAHs »Compatible with a wide range EHRs »To get started you need only email and a connection to the Internet »Can replace fax and telephone lines for health data exchange »Each provider has their “NHIN Direct email address”

6. Key Messages for States and RECs ~ NHIN Direct »Helps enable small practices and CAHs at various stages of EHR implementation to demonstrate exchange –NHIN Direct offers specifications to enable simplified interoperability between two known endpoints. Using NHIN Direct in state planning will not obviate the need for additional services, but can help in "filling the gaps" in health information exchange coverage »Helps to meet “Meaningful Use” criteria –Meaningful Use requires eligible providers to electronically exchange health data with other clinicians, and to send patients who request one a Clinical Summary in electronic format. NHIN Direct will enable meeting these criteria easily, securely, and at very low cost.

7. Key Messages for States and RECs ~ NHIN Direct »Participation in NHIN Direct can augment state HIE planning efforts –The NHIN Direct project can be invaluable for states and RECs to coordinate efforts with their colleagues in other areas. By participating in reference implementation, implementation geographies and other workgroups there is great potential for collaborative efforts, particularly for simple interstate exchange »Creates a baseline for exchange that the state can build services upon – NHIN Direct can not replace HIOs and is not a substitute for thoughtful state- level planning. States will need to layer additional necessary services over NHIN Direct to create a robust statewide health information exchange; such as provider directory, master patient index, on-demand query capabilities, record locator services, etc.

8. Call to Action »Get involved!!! –Find implementation geographies in your area and join in their efforts –Join the Wiki and participate in some of the workgroupsWiki »Include NHIN Direct in your planning –The Program Information Notice allows for NHIN Direct specifications and services to be used as the simplest means for providing HIE services which comply with national standardsProgram Information Notice –Join neighboring states in incorporating NHIN Direct in your planning »Spread the word –Publicize your involvement in the project and encourage others to join in