The Health Information Technology for Economic and Clinical Health (HITECH) Act directs the Office of the National Coordinator (ONC) for Health Information Technology to undertake activities consistent with the development of a nationwide health IT infrastructure, allowing for the electronic use and exchange of information.

The Nationwide Health Information Network (NHIN) is a key component of the nationwide health IT strategy and will provide a common platform for health information exchange across diverse entities, within communities and across the country, helping to achieve the goals of the HITECH Act.

Congress specifically directed ONC to ensure the inclusion of meaningful public input in the development of this health information infrastructure. To that end, ONC has enlisted public input through federal advisory committees, public meetings, and comments during formal rulemaking processes.

A NHIN Work Group (a new work group under the HIT Policy Committee) was formed to offer recommendations regarding a policy and technical framework that allows the Internet to be used for the secure and standards-based exchange of health information, in a way that is open to all and fosters innovation. At a very high level, the new NHIN Work Group is holding discussions on how to use the Internet to transform healthcare, including a trust framework for the NHIN, as well as access to health information.

More information on the NHIN Work Group and the HIT Policy Committee can be found at http://healthit.hhs.gov/policycommittee.

An additional effort, the Direct Project, was launched in March 2010 to specify a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. This project is limited in scope with defined outcomes. The group is initially focusing on the business cases that support meaningful use requirements for 2011. The Direct Project has more than 200 participants from over 50 different organizations. These participants include EHR and PHR vendors, medical organizations, systems integrators, integrated delivery networks, federal organizations, state and regional health information organizations, organizations that provide health information exchange capabilities, and health information technology consultants. The Direct Project’s activities are complementary to and an extension of the current Nationwide Health Information Network Exchange.

To drive adoption of the Direct Project specifications as quickly as possible, members of the community have worked together to create two reference implementations of the essential software required to run a Health Information Service Provider. One implementation is written in Java, the other using the C#/.Net collection of tools. Both are licensed under the BSD software license, a very simple license that allows commercial software vendors to incorporate these works into their own products without further obligations, or anyone else to use and modify to meet their needs. The development process, like everything else on the project, was conducted in the public from the very start, so that a wide audience could inspect the work and offer improvements and additional quality control.

For more information about the NHIN Direct Project, please visit the Project Wiki and the Project Website at http://www.directproject.org .