HIMSS Feature: FHA exec elucidates goals with open-source software
ATLANTA -- The government doesn’t want to be in the software business, said Vish Sankaran, Federal Healthcare Architecture (FHA) program director at the Office of the National Coordinator for Health IT. However, the government also didn’t want to stand by while fractious agencies go their own way–or go nowhere–when it came to health IT, Sankaran said.
This was one reason that ONC developed CONNECT, open-source software that enables exchange of health information across providers regardless of size. CONNECT is one tool being used to build the Nationwide Health Information Network (NHIN), and was demonstrated at HIMSS10’s Interoperability Showcase.
Sankaran described the FHA’s work on CONNECT in an interview with CMIO.
What was the driving force for CONNECT?
Sankaran: The FHA is a coalition of more than 20 federal agencies. There’s always been the struggle of understanding what each agency’s health IT needs are and what are the common aspects across all these agencies. People were very skeptical of how these organizations could come together to do this. But when they came to the table, they started finding common issues. For example, CMS (Centers for Medicare and Medicaid Services) is now doing clinical data processing, not just claims management. All these agencies have to talk to each other and share information about the patients across all these different boundaries.
The leaders of the agencies stepped up to develop a way to exchange information.
Where does CONNECT fit into the NHIN puzzle?
Sankaran: The NHIN is not a large database or about laying cables around the country. It is as simple as two organizations sharing data. You need to have a set of services, standards and policies, and governance. The national coordinators took the leadership role, creating the set of specifications for secure exchange of information over the Internet.
They charged the FHA with building the software, working with the agency to develop the requirements. So instead of each agency taking the specification and building their own software, they said let’s build it once and use it across agencies. We understand that we have some unique needs as part of the implementation and that is something we will handle. That’s how CONNECT was born.
By September of 2008, we had the first demonstration of a product by the secretaries of the VA (Veteran's Administration), DoD (Department of Defense) and SSA (Social Security Administration). In the Fall of 2009, we had six federal and multiple private agencies demonstrating the use of the product and one agency in production. Now we’re at 12 agencies.
The role of the government in this was to create the platform for collaboration: The same product can be used for a 19-bed facility or an organization like the VA or DoD.
What are some of your biggest challenges?
Sankaran: We cover every sector of the healthcare industry, from payor to provider to FDA and other entities, so we’re constantly relearning from the market. We release updates every three months, based on what works and what doesn’t.
Then we had to go through the certification and authentication process. We got CMS clearance last month, and DoD also. We’re doing the back end work but agencies are driving adoption across their base. A good example is the Virtual Lifetime Electronic Record. President [Barack] Obama announced in April 2009 that he wanted a seamless record for veterans or service members from birth to death. There shouldn’t be the struggle of finding their healthcare information.
Part of the thinking here is the creation of an ecosystem. The federal government is not in the business of providing free software. What we have done is we have raised the bar in the discussion. We have spent a lot of time, energy and money creating the pipes. CONNECT is the software implementation of the pipe. Organizations now compete on how to turn data going through the pipe into knowledge, based on the end user.
We can spend all the money to get people to adopt or buy EHRs, but to effectively use an EHR, it has to be something that makes a difference in their workflow and makes them more efficient.
What’s next?
Sankaran: We raised the bar, we created the pipe and we made it available. Now organizations are competing from that pipe up, rather than constantly building the pipe and then figure out how use it. We made CONNECT available to the market and now we have more than 20 different organizations building applications based on CONNECT.
We are exploring cloud computing concepts for coming versions of the product. Our goal is to reduce the workload of smaller organizations, to bring in the 40 percent of organizations that are 10 providers or less. We want to reduce the workload of an organization: If it takes 10 hours and $100 to implement a product, how do you make that $50 and five hours?
This was one reason that ONC developed CONNECT, open-source software that enables exchange of health information across providers regardless of size. CONNECT is one tool being used to build the Nationwide Health Information Network (NHIN), and was demonstrated at HIMSS10’s Interoperability Showcase.
Sankaran described the FHA’s work on CONNECT in an interview with CMIO.
What was the driving force for CONNECT?
Sankaran: The FHA is a coalition of more than 20 federal agencies. There’s always been the struggle of understanding what each agency’s health IT needs are and what are the common aspects across all these agencies. People were very skeptical of how these organizations could come together to do this. But when they came to the table, they started finding common issues. For example, CMS (Centers for Medicare and Medicaid Services) is now doing clinical data processing, not just claims management. All these agencies have to talk to each other and share information about the patients across all these different boundaries.
The leaders of the agencies stepped up to develop a way to exchange information.
Where does CONNECT fit into the NHIN puzzle?
Sankaran: The NHIN is not a large database or about laying cables around the country. It is as simple as two organizations sharing data. You need to have a set of services, standards and policies, and governance. The national coordinators took the leadership role, creating the set of specifications for secure exchange of information over the Internet.
They charged the FHA with building the software, working with the agency to develop the requirements. So instead of each agency taking the specification and building their own software, they said let’s build it once and use it across agencies. We understand that we have some unique needs as part of the implementation and that is something we will handle. That’s how CONNECT was born.
By September of 2008, we had the first demonstration of a product by the secretaries of the VA (Veteran's Administration), DoD (Department of Defense) and SSA (Social Security Administration). In the Fall of 2009, we had six federal and multiple private agencies demonstrating the use of the product and one agency in production. Now we’re at 12 agencies.
The role of the government in this was to create the platform for collaboration: The same product can be used for a 19-bed facility or an organization like the VA or DoD.
What are some of your biggest challenges?
Sankaran: We cover every sector of the healthcare industry, from payor to provider to FDA and other entities, so we’re constantly relearning from the market. We release updates every three months, based on what works and what doesn’t.
Then we had to go through the certification and authentication process. We got CMS clearance last month, and DoD also. We’re doing the back end work but agencies are driving adoption across their base. A good example is the Virtual Lifetime Electronic Record. President [Barack] Obama announced in April 2009 that he wanted a seamless record for veterans or service members from birth to death. There shouldn’t be the struggle of finding their healthcare information.
Part of the thinking here is the creation of an ecosystem. The federal government is not in the business of providing free software. What we have done is we have raised the bar in the discussion. We have spent a lot of time, energy and money creating the pipes. CONNECT is the software implementation of the pipe. Organizations now compete on how to turn data going through the pipe into knowledge, based on the end user.
We can spend all the money to get people to adopt or buy EHRs, but to effectively use an EHR, it has to be something that makes a difference in their workflow and makes them more efficient.
What’s next?
Sankaran: We raised the bar, we created the pipe and we made it available. Now organizations are competing from that pipe up, rather than constantly building the pipe and then figure out how use it. We made CONNECT available to the market and now we have more than 20 different organizations building applications based on CONNECT.
We are exploring cloud computing concepts for coming versions of the product. Our goal is to reduce the workload of smaller organizations, to bring in the 40 percent of organizations that are 10 providers or less. We want to reduce the workload of an organization: If it takes 10 hours and $100 to implement a product, how do you make that $50 and five hours?