In July 2004 the United States Department of Health and Human Services released their vision of how America’s healthcare system could be rebuilt during the next decade. That vision is in the process of maturing and the lead in this effort is the Office of the National Coordinator for Health Information Technology. The position of National Coordinator was created in 2004, through an Executive Order, and legislatively mandated in the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009. With the passage of the HITECH Act, the Office of the National Coordinator for Health Information Technology (ONC) is charged with building an interoperable, private and secure nationwide health information system and supporting the widespread, meaningful use of health IT (Reference Wikipedia).

Two key missions of ONC are

  • Strategic planning for HIT adoption and health information exchange
  • Establishing governance for the Nationwide Health Information Network. (NHIN)

NHIN Adoption

The business, trust and technical arrangements that will enable the NHIN generally will be local and between organizations. Nonetheless, the primary users of the NHIN will be people: healthcare providers, healthcare consumers and those who use the data in the NHIN for public health, quality assessment or other purposes. These people will have several ways to take advantage of the information exchange available through the NHIN.

Access Paths to the System

For healthcare providers:

  • Providers may use features of the electronic health record (EHR) systems of their own practice or hospital to connect to an HIE, and the HIE, in turn, will support information exchange with other EHRs or PHRs on that HIE or on other HIEs through the NHIN
  • They may not have an EHR, so they may use the Web to access a portal operated by the HIE to accessz information.

For healthcare consumers:

  • They may use features of a PHR that they designate as the repository of their personal health record, and that PHR may be connected to an HIE which, in turn, will provide a connection to the NHIN;
  • They may use features of a multi-regional PHR that will participate directly in the NHIN;
  • If they do not have access to a PHR, they may achieve some limited functionality by using the services of an HIE through its portal.

AFour Technologies have been assisting Healthcare Information Software Vendors and EMR Software Vendors in independent verification and validation of their productsFor HIE software vendors AFour has provided following key services:

  • Testing of Enterprise Master Patient Index (EMPI)
  • Testing of Document Registry and Repository
  • Testing of HL7 compliance
  • liTesting of IHE protocol compliance (PIX, PDQ, XDS.b, ATNA, XCA, XCPD)
  • Consent Management Testing according to HIPAA Compliance
  • Testing of Audit Logging
  • Testing of integration with Microsoft applications like HealthVault PHR, Amalga
  • Integration Testing of HIE solution with third party EMR systems
  • Performance Testing
  • Security Testing
  • Testing over cloud infrastructure
  • API Testing through web services layer
  • For EMR software vendors AFour has provided following key services:
  • CCHIT pre-certification of Ambulatory EHRs
  • HL7 interoperability with HINs / HIEs
  • Practice Manager Testing
  • Testing of Patient Demographic Information Updates
  • Performance Testing
  • Security Testing
  • Test Automation