The 5th Nationwide Health Information Network Forum, held this week in Washington, D.C., showcased the groundbreaking work of the Nationwide Health Information Network (NHIN) trial implementations which began more than 14 months ago. This work, carried out by members of a public-private "NHIN Cooperative," lays the foundation that will serve as the next step toward secure nationwide interoperable health information exchange. By making information available when and where it is needed, nationwide exchange of health information promises to increase health care quality, reducing both cost and medical errors.

Security of information and protection of privacy are essential to information exchange. In his keynote address to open the forum, HHS Secretary Mike Leavitt announced a privacy and security doctrine, made up of eight principles, and a complete tool kit to guide efforts to ensure consumers have protected access to their health information (Privacy and Security Framework). Secretary Leavitt emphasized the relationship between these privacy and security measures and the groundbreaking technological advances demonstrated by the NHIN.

As of October 2007, several forces converged to create a broadly-based NHIN Cooperative. HHS awarded contracts totaling $22.5 million to nine health information exchange organizations to begin trial implementations of the NHIN. Federal chief information officers recognized the importance of exchanging health information. As a result, the Department of Veterans Affairs, the Department of Defense, the Social Security Administration (SSA), and the Indian Health Service joined the NHIN Cooperative. Since that time, the Centers for Disease Control and Prevention, the National Institutes of Health's National Cancer Institute and six additional grantees from the private sector also joined the effort.

"The work of the Nationwide Health Information Network has come a long way in the last year to create a health information exchange environment that fosters public-private cooperation to empower consumers to benefit from electronic health information," Secretary Leavitt said. "We need to continue to encourage the development of electronic health information exchange that balances each individual's right to access their health information and provide robust protection and security of personal health information."

The trial implementations have engaged communities across the United States and have served to demonstrate interchanges of health information across different types of organizations and regions of the country. While the information exchanged was based on fictitious "patients," the exercises reflected real health care conditions.

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