One of them is real software and the other is an emerging recipe for connectivity. Here's a primer.
CONNECT is downloadable networking software with three components:
* Gateway, which implements nationwide health information network specifications for secure data exchange over the Internet;
* Enterprise Service Platform, which enables an organization to plug practice management and electronic health records systems into a framework to communicate with the Gateway; and
* Universal Client Framework, a platform to develop end-user applications that support meaningful use in lieu of a full-blown EHR.
CONNECT includes one or more open source applications for each of the components, plus some private vendor tools such as IBM/Initiate Systems' master patient index software.
The Department of Health and Human Services in March 2008 awarded a contract to Melbourne, Fla.-based Harris Corp. as the prime contractor to develop CONNECT. Chantilly, Va.-based Agilex Technologies and Richardson, Texas-based Scenpro Inc. also are involved in the project as subcontractors.
The Federal Health Architecture initiative, a collaboration of multiple federal departments and agencies, in April 2009 released CONNECT's source code as open source and began developing the open source community.
Releases are announced on a quarterly basis, says David Riley, CONNECT initiative lead contractor and owner of Enaptics Consulting LLC, Marshall, Mo.
Organizations using CONNECT, some in full production and others in various testing stages, include HealthBridge in Cincinnati, Thayer County Health Services in Nebraska, Indianapolis-based Regenstrief Institute, the Departments of Defense and Veterans Affairs, Kaiser Permanente, and Orange County and Redwood MedNet in California.
More of a policy initiative, NHIN Direct isn't developing connectivity software, but the tools to guide development. These include descriptions of standards, services and policies to enable secure health data transmission over the Internet.
While CONNECT was done to meet certain needs of government agencies and large organizations, NHIN Direct is focused on more modest goals by smaller entities, such as physician-to-physician or physician-to-laboratory connectivity. It builds off CONNECT to offer an additional set of standards and specifications to support point-to-point interactions for meaningful use of health information technology, says Doug Fridsma, M.D., acting director of the office of standards and interoperability in the Office of the National Coordinator for Health Information Technology.
"Knowing where to send information will require directions to make sure it goes to the right place," he explains. "Part of the project is to determine what is the right way to do it."
NHIN Direct was formally announced in early 2010 and the initial goal is to test specifications this summer. Working groups are tackling such issues as directories and security.
The initiative won't create software but set the groundwork for development of a less-complex version of CONNECT that is suitable to the data exchange needs of smaller organizations, Fridsma says. The goal, he adds, is to get a simple but robust set of specifications, and build innovations on them. For more, go to http://nhindirect.org and connectopensource.org.
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