National (I mean, Nationwide) Health Information Network, Round 2

The next round of Nationwide Health Information Network projects is set to launch. For those who missed Round 1, the Office of the National Coordinator (ONC) let 4 contracts a couple of years ago to consortia led by large IT-type companies to develop prototypes for a Nationwide Health Information Network (which was, at the time, called the National Health Information Network). Those companies were: Accenture, Computer Sciences Corporation, IBM, and Northrop Grumman.

The contracts were originally let under David Brailer, the past head of ONC, but he left while the contracts were underway. Looking at the work undertaken by these groups and the ensuing "deliverables" resulting from those contracts, many of us are left scratching our heads about what the NHIN prototypes were supposed to accomplish in the first place. You can judge for yourself by looking at the results of the 3rd NHIN Forum held earlier this year.

So, fast forward to the present. Late last week a "pre-solicitation notice" appeared quietly on the FedBizOpps website. The synopsis reads as follows:

As part of advancing the President's Health Information Technology agenda, the Office of the National Coordinator for Health Information Technology (ONC) of the U.S. Department of Health and Human Services (HHS), will be soliciting proposals to establish Nationwide Health Information Network Trial Implementations. The purpose of this project is for state, regional and non-geographic health information exchange consortia to become components of the "network of networks" that is the nationwide Health Information Network (NHIN). These consortia should combine inclusive organizational governance and trust relationships, provider organizations and healthcare markets, consumer applications and participating consumers, existing health exchange activities and technical expertise. Each Contractor shall work cooperatively with the other contractors to develop specifications for, and trial implementations of, the NHIN, and test these trial implementations with each other to ensure that they can all work together to implement an interoperable "network of networks" - built on top of the Internet. The trial implementations shall demonstrate core services, exchange summary patient records and support the capabilities outlined in several AHIC use cases based on shared NHIN standards and specifications. The trial implementations shall demonstrate the represented information exchanges with provider organizations, personal health records, specialty networks, and the other NHIN contractors. This is a partial small business set-aside with up to a third of the contracts awarded to small businesses. We anticipate the award of up to 10 contracts. The period of performance shall be for a period of 1 year, with two 1-year options. Options will be evaluated with the base period. Options may or may not be exercised based on performance of the contractor and the needs of the Government.

I don't really know what all of the above means -- there was a public conference call yesterday which I wasn't able to attend, and the full solicitation won't be released for another 2 weeks. We're still struggling nationally, regionally, and locally with the question of how to get this "health IT thing" done within a political-economic system that: 1) professes to be market-driven, 2) is timid about admitting how much is actually government-driven, and 3) thus has a hard time figuring out how to respond when the market fails. Perhaps the NHIN Round 2 program will provide some answers.