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Nationwide Health Information Network hackathon: Direct Project reaches milestoneWhen the Direct Project (a component of the Nationwide Health Information Network) announced its first hackathon yesterday I felt personally gratified as well as excited to see the achievement of this milestone. The hackathon will take place on October 27 and 28 and can benefit from the participation of any programmers using Java and C#. The Nationwide Health Information Network is the U.S. government's major open source initiative in health care. You could argue that VistA, from the U.S. Department of Veterans Affairs, is more important (it certainly is a vastly bigger code base), but VistA so far is sparsely adopted outside the government, whereas the Nationwide Health Information Network is positioned to become the platform for all hospitals, clinics, doctors' offices, and other health care institutions to exchange information throughout the country. The basic goal of this network is to allow health care providers to exchange data on patients who move from one institution to another. This could be an everyday occurrence such as a referral, or an emergency situation such as a patient's ER visit during travel. The network will also facilitate the collection of data to government agencies that do important work in health care statistics and evidence-based medicine. What makes this all hard is the strict privacy requirements that call for careful authentication and secure data transfer; that's why special code is necessary. Intermediaries are also required to help health care providers authenticate each other, and help providers that don't have special security-enhanced software to encrypt their data exchanges. The original network rested a complex SOAP implementation that had only scattered implementations and required most institutions to hire consultants. The Direct Project will reimplement the security and authentication through simpler protocols, starting with garden-variety email. Doctors span a wide range of technical capabilities. Some are barely storefront operations who consider themselves lucky to have PCs with consumer-grade email clients. Others can afford special software that supports S/MIME for encryption. The Direct Project has to encompass all these participants. So the interface presented to health care providers will be as simple as possible, but the implementations have to be sophisticated and flexible. This project has been conducted with the highest degree of openness from the start. Anyone who's interested can join a working group (I dropped in on the Documentation and Testing group to review documents) and a wide range of volunteers from major health care providers and EHR vendors have been collaborating. From the conference calls and email I've been on, things look very collegial and orderly. The upcoming hackathon is the natural next stage in this open process. The Nationwide Health Information Network has held hackathons before, but this one is the first for the Direct subproject and shows that it's reaching a viable stage. A reference implementation for the platform is nearly ready, but that's only one node in a fairly complicated architecture. For doctors to connect to the network, client software and other mediators are needed. So if you're a programmer with an interest in health care, check out the hackathon. It's a chance to see where health care is going in the United States, and help make it happen.
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