ONC has supported development of nationwide health information network, including standards, services and policies to support nationwide exchange of health information since 2004. Beginning in 2009, a group of federal agencies and non-federal entities began exchanging health information based upon an initial set of specifications, services, testing resources and legal and support framework developed during the NHIN Trial Implementation.
These early implementation experiences help inform ongoing development and adoption of nationwide health information network standards, services and policies.
This group, now called the Nationwide Health Information Network Exchange, is a confederation of trusted entities, bound by mission and governance to securely exchange health information.
Who is engaged in this effort?
A growing number of organizations are exchanging health information as part of the Nationwide Health Information Network Exchange. By the end of 2011, it is expected that approximately 35 entities, including hospitals, IDNs, HIOs, state HIEs, beacon communities and other networks will be securely sharing health information as part of this Exchange.
Participants (as of 12/05/11):
What capabilities are currently supported?
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Exchange of summary patient records for care coordination, including the Virtual Lifetime Electronic Record (VLER)
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Exchange of summary patient records for SSA disability determination purposes
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Biosurveillance and case reporting to CDC
Who Can Engage in this Activity?
Any organization can utilize the resources developed and used in the Exchange. For more details, see “How Can I Learn More” below.
HITECH requires that ONC establish a governance mechanism for the nationwide health information network. In response to this requirement, ONC is initiating a rulemaking process for governance.
Which federal agencies have nationwide health information network-related contracts?
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Centers for Disease Control and Prevention contracts to receive biosurveillance data
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Social Security Administration
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ONC - Beacon Communities
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ONC - State HIE Cooperative Agreements
NOTE: Organizations interested in exchanging data as part of the Exchange are encouraged to coordinate with one of the current non federal Exchange Participants listed above or with their respective state’s HIE efforts.
Federal agencies are assessing and prioritizing their rollout strategy for building their connectivity and will prioritize their expansion of health information exchange over the next 12 to 18 months.
How Can I Learn More?
The technical specifications, testing resources, legal agreements and Committee operating policies and procedures are available to stimulate implementation of secure electronic health information exchange.
Specifications Currently in Effect
Revised Specifications (Production Effective Date TBD)
NwHIN Exchange Validation Plan and Testing Materials
Data Use and Reciprocal Support Agreement (DURSA)
Exchange Coordinating Committee
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Participants have organized a support structure and utilize a Coordinating Committee to oversee their activities. The work products of this Coordinating Committee, are available on the NwHIN Exchange Coordinating Committee page.
How to engage in this activity
Entities that are interested in learning more about participating in the Exchange should visit the Exchange OnBoarding wiki. 
