ONC to Issue Proposed Governance Rules for NWHIN by the End of the Year

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The Office of the National Coordinator for Health Information Technology plans to release a proposed rule by the end of the year defining the governance structure for the Nationwide Health Information Network (NWHIN), an agency official said June 14 at the Healthcare Information and Management Systems Society Government Health IT conference.

Doug Fridsma, director of ONC's Office of Interoperability & Standards, said that establishing NWHIN governance rules should foster greater participation from health IT industry stakeholders in developing technical solutions still needed for the national interoperable exchange of health information.

Congress called on ONC in the Health Information Technology for Economic and Clinical Health (HITECH) Act to develop a governance structure for NWHIN.

ONC defines NWHIN (formerly called NHIN), as a set of services, standards, and policies that enable the secure exchange of health information over the internet. Using the NWHIN infrastructure, ONC has launched two pilot projects aimed at facilitating health data exchange involving federal agencies and providers. The Nationwide Health Information Exchange allows federal agencies to share health program beneficiary data and population health data. The Direct Project allows providers—particularly small providers—to exchange data directly among electronic health records, rather than rely on printing and faxing copies of information from one EHR and manually entering it into another EHR, Fridsma said.

The NWHIN governance structure, Fridsma explained, will establish specifications for a trusted exchange environment, and will require participants in NWHIN projects to adhere to the same set of standards for electronic health information exchange.

ONC is developing the proposed rule using recommendations from the Health IT Policy Committee, which provided guidance on the scope and focus of the governance structure, he said.

Without a governance mechanism in place, Fridsma said, ONC's efforts to test exchange capabilities under the NWHIN are limited. For example, currently, exchange activities piloted under the NWHIN umbrella must be covered under existing federal contracts or agreements. That will change with a permanent governance structure in place, meaning more health IT firms in the private market will be able to participate in NWHIN activities, he said.

The governance rule also will provide assurance that the conditions exist for nationwide interoperability and trusted exchange to occur, Fridsma said. Likewise, the rule will provide for necessary oversight, enforcement, and accountability.

By Kendra Casey Plank