Frequently Asked Questions

Why use ApeniMED for my HIE, State Agency or Federal Agency?
How secure are ApeniMED HIE Solutions?
What is NHIN?
What is a Health Information Exchange (HIE)?
How do I build an HIE?
Why has ApeniMED adopted the NHIN standards?
What are the NHIN Standards?
What Federal Services are available via NHIN?
What are the technical details on NHIN?
How do I get started?

Why use ApeniMED for my HIE, State Agency or Federal Agency?
The ApeniMED team has extensive, unsurpassed national experience with Health Information Technology, including Health Information Exchange (HIE) and Federal and State Agency interoperability. ApeniMED has architected, designed and implemented multiple regional, statewide and national HIEs, as well as worked with multiple State Medicaid Agencies (SMA), State Public Health Agencies, and Federal Agencies/Federal projects. ApeniMED is an expert in, and fully certified with both NHIN Exchange (CONNECT) and the Direct Project (NHIN Direct), core infrastructure of the Nationwide Health Information Network. The ApeniMED Platform is a proven healthcare interoperability connectivity solution stack, enabling the interoperable exchange of clinical and administrative data between disparate trading partners and systems.  The ApeniMED Platform has been deployed to build Health Information Exchanges from the ground up, connecting disparate EHRs, laboratory systems, payers, providers, and other stakeholders together for the secure, interoperable exchange of clinical and administrative data.  The ApeniMED Platform has also been deployed to connect existing HIEs together with other HIEs, State Agencies, Federal Agencies, vendors, and stakeholders.

How secure are ApeniMED HIE Solutions?
Patient privacy, HIPAA compliancy and military-grade security are standard in the ApeniMED Platform, including full support of Public Key Infrastructure (PKI) encryption for all data in transit or at rest. The ApeniMED Privacy and Trust Manager ensures user compliance and authorization, providing data access only to users with the “right to know”, “need to know”, and “permission to know”. The Privacy and Trust Manager also provides sophisticated ‘Opt-in / Opt-out’ options for patients, giving them detailed control of access to their health information. Additionally, the ApeniMED Platform design allows for patient data to remain at the client location (behind the client firewall), ensuring there is no common or centralized data store that could be vulnerable to security threats.

What is NHIN?
NHIN stands for the Nationwide Health Information Network, an internet-based “network of networks”. NHIN was developed by the US Federal Department of Health and Human Services, Office of the National Coordinator for Health IT, commonly known as the ONC. NHIN runs over the Internet and connects Federal Agencies, State Public Health Agencies, State Medicaid Agencies (SMA) and provider group such as hospitals, clinics, and similar organizations. ApeniMED has expertise in NHIN standards, including NHIN Exchange (CONNECT) and the Direct Project (NHIN Direct), for securely sharing disparate healthcare information over the Internet. The ApeniMED Platform is fully tested and compliant with NHIN and ONC’s NHIN CONNECT software, and is listed as a partner and adopter on the ONC NHIN CONNECT website at www.connectopensource.org.

What is a Health Information Exchange (HIE)?
A Health Information Exchange (HIE) is any group of hospitals, clinics, public health and/or other healthcare organizations that band together to securely share healthcare information between disparate systems. HIEs are often organized within a city, a country/region, or at a state level. The ApeniMED Platform was designed so that all of these HIEs can use the ApeniMED Platform to connect to the Federal Government or other HIEs.

How do I build an HIE?
Building an HIE is a complex undertaking. ApeniMED works with customers to minimize the challenges of implementing and managing an HIE. Our goal is for customers to feel like the HIE implementation is straightforward, making a complex process simple and easy. An HIE requires not only technology, but overall policies about operating the HIE, building a sustainable HIE and governance/participation in the HIE. ApeniMED has also partnered with experts in the HIE operational and functional training and consulting space. By partnering with these experts, ApeniMED provides a complete HIE solution – technology, connectivity, operational and organizational training and planning, and a pathway to Meaningful Use.

Why has ApeniMED adopted the NHIN standards?
The ApeniMED Platform is a hardened, proven, SaaS-based offering that utilizes standards-based technologies such as NHIN Exchange (CONNECT) and the Direct Project (NHIN Direct) to connect disparate healthcare stakeholders and systems together for seamless data exchange, all while helping providers achieve Meaningful Use. The core components of NHIN, including NHIN Exchange (CONNECT) and the Direct Project (NHIN Direct), are modern and secure technologies based on open standards, and are backed the United States Government as a key piece of the Federal Health Architecture (FHA).

What are the NHIN Standards?
NHIN defines a large number of standards to ensure that communications using this system are secure and can connect to everyone on the network. NHIN also has a set of policies that ensure it is only used for secure, private communications between participants. ApeniMED developers chair some of the NHIN committees and influence the design of new services, ensuring ApeniMED maintains its expertise and our customers have full compliance with NHIN standards and the Federal Health Architecture (FHA).

What Federal Services are available via NHIN?
Since 2007, ApeniMED has architected, designed and implemented custom NHIN interfaces for key Federal and State Agencies, including: the Social Security Administration (SSA), Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS), the Department of Defense (DoD), the Veterans Administration (VA), State Medicaid Agencies (SMA), and State Public Health Agencies. ApeniMED is currently working on adding connectivity to Indian Health Services (IHS) and the Food and Drug Administration (FDA).

• Social Security Administration (SSA): The United States Social Security Administration (SSA) is the first agency to develop a large NHIN capability. ApeniMED was the first in the nation to connect healthcare providers to the SSA with the ApeniMED NHIN Platform, streamlining the formerly paper-based disability claims process. Automating this process allows injured workers to get their benefits faster, receiving benefits in days rather than months.
• Centers for Medicare and Medicaid Services (CMS): ApeniMED architected, designed and implemented a custom CMS esMD interface, allowing the streamlining of the submission of medical documents in compliance with the over 100 page CMS esMD implementation guide.
• Centers for Disease Control and Prevention (CDC): ApeniMED provided the architecture, design, and implementation of NHIN interfaces to support the bi-directional exchange of CDC specific data and transactions to and with the CDC from State Agencies and Public Health Agencies.

What are the technical details on NHIN?
NHIN is based on a modern SOA architecture using the latest PKI security architectures. All of the services are SOAP-based defined by WSDL files. Adding new services is usually adding additional service definitions via WSDL approved by the NHIN architecture committees. All communications are encrypted with client-server authenticated TLS connections to ensure security and trust between servers. Additionally, each NHIN message is encrypted and digitally signed to ensure each message is secure and unchanged as it is routed over the Internet. Each NHIN message includes a SAML2.0 header which can contain an identity assertion from a trusted identity management system.

How do I get started?
Contact one of our experts at ApeniMED about how we can help your HIE, State Agency, or Federal Agency and you will be on the path to interoperability and Meaningful Use!