On the Road Again with NHIN Direct

What a difference a few weeks and TONS OF WORK can make!

Folks in the office are now convinced that I'm completely bipolar. My mood and outlook on life has shifted from minute to minute since my last NHIN Direct post after our face-to-face meeting in Redmond. We're on, we're hosed, not sure, looks great, oh crap.... Repeat!

But I think we can safely say, as Arien did in his most recent official post (best tease on the misspelling of "Houston" goes to Janet Campbell), that we are at least for now in the clear and can see a path towards getting simple messaging going in the real world before the end of the year.


So where did we end up? Well, the official consensus statement basically calls out three things (I'm paraphrasing here and the words in the proposal were chosen very carefully, so please use that as the "golden" document):

  1. The baseline protocol for exchanging messages will basically be secure email --- an SMTP transport carrying RFC5322-formatted messages signed and encrypted using S/MIME. We have added some additional restrictions to the S/MIME standard (and some of the details are in flux), but at the highest level --- secure email is the base.
  2. For entities using IHE/NHIN systems, the recommendation is to "short-circuit" the baseline protocol and use a to-be-slightly-modified XDR exchange when it is known in advance that the recipient can handle that format. These entities must also support the baseline SMTP protocol, but this recommendation provides a path towards migration as/if adoption of the IHE stack accelerates.
  3. In our reference implementations, we will create a number of transformations and alternate interfaces, so that developers have the maximum flexibility in integrating NHIN Direct into their products and services.

In the totally wicked department, I got the opportunity to duck down to Santa Rosa (home of Charles Schultz I found out when I got there!) last Friday to participate in a demo of the "current state" of NHIN Direct at the Redwood MedNet "Connecting California" HIE conference. The demo involved folks from Redwood MedNet, Mirth, MedPlus, Microsoft and the Western Health Information Network --- sending data from Care360, to Mirth, to Outlook and then on to HealthVault. The first public demonstration of NHIN Direct --- cool beans!

Now of course we enter the next phase of this journey --- and we have to start building for real deployment and use. After a brief hiatus to celebrate the Fourth, here at Microsoft we're back in business. Umesh is busy working on v2 of and writing a detailed spec for the S/MIME "agent" so that we can nail down final details. I am trying to close out the Security & Trust workgroup recommendations and build an initial project plan for a .NET reference implementation. It's going to be a busy summer --- especially with a pretty chaotic travel schedule between now and August. Party on, Garth!

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