On of the most obvious issue that I have noticed in the NHIN_direct meeting is that they bypassed the states HIE. HIPSP advocated a top down approach which normally is not concerned with the small practice. I for one, have written several article about these flaws. So it seems that the NHIN is attempting to rectify this issue. The problem is that it bypasses the HIE by providing a simple connection (sort of) to the NHIN and will cause completion for the state's initiative of the HIE. Note: the providers in a state will be able to send data to other intra-state providers with this system.
Consent verification will be place on the originator(see DURSA) which could reduce by-in because of risk.
Jeff Brandt
www.comsi.com
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