Universal IT translator tackles incompatibility in health network scheme

A Rosetta Stone-like scheme demonstrated at the third Nationwide Health Information Network Forum resolves IT incompatibility issues by translating information as it passes through the system. This universal translator from Northrop Grumman was one of the most potentially significant of the network prototypes shown at the conference held in Washington, DC, last month.

"We don't store anything, we don't normalize anything, we translate on the fly," said Robert Cothren, Ph.D., a program director at Northrop Grumman.

Compatibility between systems - user interface, system architecture, and functionality - can vary significantly. A translation facility, or information broker, that can resolve incompatibility issues would help achieve the goal of a nationwide health information network.

The defense giant was one of four high-profile companies at the Forum demonstrating national health network prototypes, inching the country closer to the reality of nationwide health information exchange. Other firms presenting were IBM, CSC (Computer Sciences Corp.), and Accenture.

Northrop Grumman's solution connected national laboratory, pharmacy, and public health systems with three existing market segments:

• Santa Cruz regional health information organization (RHIO) in California

• University Hospitals, an established academic RHIO in Cleveland

• a new exchange initiative in Mesa County, CO, called Quality Health Network

Cothren said any national network will have to adopt to the more than 1000 different standards used in healthcare IT, because translation responsibility can't realistically be placed on either the receiving or transmitting system.

"It's less expensive and much easier to connect disparate systems that speak different languages if there's a central point responsible for data translation," he said.

Northrop Grumman intends to pursue this as a business opportunity.

The goal of the Forum was to demonstrate the viability of national healthcare information exchange, to better inform clinicians at the point of care and allow patients to control what information is given to whom.

Accenture, for instance, demonstrated a large-scale standards-based network that allows secure information sharing among hospitals, physician practices, pharmacies, nursing homes, and laboratories.

CSC presented an open standards vendor-neutral "thin" approach based on the Connecting For Health Common Framework. Any entity that complies with Framework standards and policies can participate in data sharing under this model, the company said.

The CSC solution does not require centralization of information. Rather, data are held by organizations at the network's edges, where they are created, consumed, and protected. Data can then be shared based on patient and provider preferences.

IBM demonstrated how a patient's personal health record containing medication history, recent lab results, and current blood sugar readings from a monitoring device is made available through the health information network. The demo showed live patient data moving through the network in real illness-related episodes. Patient data could be seen flowing from the personal health record to the physician's practice, reference laboratory, and even the hospital electronic medical record. The system can also identify biosurveillance data, deidentify this information, then transmit it to appropriate public health departments.