Gateways

The Nationwide Health Information Network
The Nationwide Health Information Network is a set of standards, protocols, legal agreements, and specifications that a consortium of health information organizations have agreed are necessary for secure and private exchange of health information over the internet. The Nationwide Health Information Network is overseen by the Office of the National Coordinator for Health IT (ONC).

• Nationwide Health Information Network Direct is designed to allow simple, secure transmission of health information between two known providers. Due to the large volume of medical documentation involved, the CMS esMD team is NOT planning to use Direct.
• Nationwide Health Information Network Exchange is designed to connect a diverse set of federal agencies and private organizations to securely exchange electronic health information. CMS believes the Exchange holds promise and intends to use it during the esMD program. More information on Exchange can be found by clicking the "Exchange" link below.

Gateways
Like the interstate highway system, on-ramps and off-ramps are critical! On the Nationwide Health Information Network, on/off-ramps are called "gateways." A gateway connected to the Nationwide Health Information Network must meet certain ONC-prescribed security standards.

CMS' esMD Gateway
CMS hired QSSI to be its esMD gateway contractor. CMS requires QSSI to use "CONNECT" software to build the CMS esMD gateway. More information about CONNECT software can be found at www.connectopensource.org.

Providers' Gateways
Any provider that wants to electronically submit medical documentation to a CMS Review Contractor must either 1) build a gateway,  or 2) procure gateway services from the Health Information Handler (HIH) of their choice. For more information on which HIHs are currently participating in the CMS esMD program, click the link at the left called "Which HIHs Offer esMD Gateway Services to Providers?"

Who Can Join the Exchange?
Currently, ONC limits the use of Exchange to only federal agencies and private organizations that have a contract, grant or cooperative agreement with a federal agency. In 2012, ONC plans to allow private organizations without federal contracts/grants/agreements to participate in Exchange. When this occurs, the esMD HIHs will join Exchange. Prior to August 2012, the HIH esMD gateways will submit medical documentation directly to the CMS esMD gateway.

The following link is an overview of the esMD Program, the process and the status of upcoming phases.  This also provides any Health Information Handler (Claim Clearinghouse, Electronic Health Record Vendor, Health Information Exchange (HIE), Regional Health Information Organization (RHIO), Release of Information (ROI) Vendor, etc) and those interested in participating in the esMD Program, the opportunity to submit their information by following the link below under the related links outside CMS section "esMD Questionnaire."