SSA becomes first to log on to national health network

The decision to use the Nationwide Health Information Network to support processing disability claims is viewed as a boon to the government's push for more use of electronic health records.

The Social Security Administration announced on Wednesday that it will become the first agency to use the national network the federal government is promoting to exchange electronic health records.

The Nationwide Health Information Network, which allows interoperable exchange of health care information between multiple federal agencies and private sector providers, will cut the time it takes to obtain claimants' records from months to a matter of seconds, said Debbie Somers, senior deputy adviser to the agency's deputy commissioner. SSA handles about 2.6 million disability claims a year through a mostly paper-based process, which costs about $500 million a year to operate, she added.

Under the current disability claims process, SSA asks doctors or hospitals to provide paper health records, which the agency scans into a computer system. A medical examiner then checks the electronic version of the health record. This labor-intensive process can take up to nine months.

When SSA starts using the health information network next year, the agency will be able to issue an electronic request for a record to participating institutions and "get a response in 42 seconds," Somers said.

The electronic record also will include the standard International Classification of Diseases and Related Health Problems-9 Codes, which will help examiners process claims quicker, she added.

The Office of the National Coordinator of Health Information Technology, which is part of the Health and Human Services Department, began promoting the network three years ago to support President Bush's initiative to provide most Americans with electronic healthy records by 2014. It developed a gateway to the system in less than a year.

SSA plans to kick off its use of the network with MedVirginia, a Roanoke, Va.-based regional health information organization, and later with the North Carolina Healthcare Information and Communications Alliance and Kaiser Permanente, the nation's largest private health care provider.

The project is "a giant step forward in bringing efficiency to they medical claims process and shows that electronic medical data has uses outside a purely clinical setting," said Michael Matthews, chief executive officer of MedVirginia.

The agency plans to expand to nationwide use of the network to speed its processing of health claims as more states, regions and private providers connect to the health information network. John Cook, an analyst with Suss Consulting, said SSA's embrace of the national network moves electronic health records from concept to reality providing "real benefits to real people."

The software glue that connects the agency to private health care providers is gateway software that provides speedy, secure and interoperable exchange of medical information with health care providers such as MedVirginia, according to Somers.

Dave Riley, a contractor working on the federal agency project NHIN Connect, said planning started in October 2007 to develop standards based services and tools to support interchange of medical data. Tony Galluscio, a Harris NHIN Connect project manager, said it then took his company only nine months to develop the gateway software, which was demonstrated this week at NHIN Forum in Washington.

The gateway uses Web services and health information technology standards, such as Health Level 7 messaging and open source software from Sun Microsystems, including Java and JavaBeans. The software supports services such as discovery of records, record requests, messaging and query and audit logs.

The framework was developed and embraced by a range of federal agencies besides SSA, including the Defense Department's Military Health System, the Veterans Affairs Department, the Centers for Disease Control and Prevention, and the Indian Health Service, said Vish Sankaran, program director for federal health architecture at the Office of the National Coordinator of Health Information Technology.

The gateway software was developed quickly because of an interest among the agencies to collaborate and to support business processes, said Bart Harmon, chief medical officer for Harris Healthcare Solutions.

Sankaran said the Military Heath System and VA need the gateway to support exchange of medical information with private providers, which handle 60 percent of the health care services for Defense and 40 percent for VA.

The gateway software is open source and free to private organizations to support interchange of medical information with federal organizations, Sankaran said. He expects the Military Health System and VA will use the gateway to exchange information with private health care providers in late 2009.