NHIN versus the iPhone

The National Health Information Network is going to be a set of protocols laid on top of the current Internet to assure the identity, privacy, and security of medical record transfers.

Any device that can create a computer file, or transmit one, will in theory become part of it over time. Each doctor, clinic and hospital will become a member of the network, get the necessary software, and off we go into the future.

But that's not how things began. Regular readers will remember my March visit with Jim Traficant of Harris Corp., who showed off the NHIN Connect system his company built under contract with the Defense Department.

That system is built to DoD specifications. It is expected to become a sort of glue connecting military records to those of the Veterans Administration, letting the government fulfill a long-held goal of a single health record that can follow our heroes from induction through retirement.

In the wake of NHIN Connect a lot of vendors with defense experience are now calling themselves NHIN ready. To the right is an example from echoBase, an iPad application using a French integration program called ENOVIA.

Very cool. But doctors in small practices can't wait for the benefits of NHIN Connect to trickle down to them, complete with super-secure technologies like ENOVIA or iPad applications from echoBase.

What they are looking to instead is something much simpler, called NHIN Direct, now evolving at the Department of Health and Human Services.

The difference between the two can be visualized as that between a company which processes Visa transactions and a merchant taking Visa cards. The first has to meet a complex set of ever-changing terms and conditions. The second just needs a terminal that connects to a processor.

Health reformer David Kibbe writes of Health ISPs being created within a matter of months, whose job will be to verify the identities of doctors, give them the software tools they need, and encrypt e-mails containing medical data traveling over the existing Internet.

To continue with the credit card analogy, Health ISPs would be like those resellers who work with banks to get terminals into the hands of merchants. Doctors would be the merchants. The cost of using the terminal would be higher than just sending an e-mail, but there would be security and privacy for the data.

So if, next year, your doctor wants a cool iPad application that sends your x-rays back from the imaging clinic and on to the orthopedic surgeon, he can get one. Without paying a defense contractor's price.

This is the difference between building a Health Internet from scratch and using what we know of security to create something that rides on top of it, something your doctor can use.

And that's even cooler than an iPad app.

This post was originally published on Smartplanet.com