Introducing NEHEN 3.0

NEHEN aims to enhance health data exchange and process automation for payers and providers in the coming years. NEHEN is evolving from NEHEN 2.0 to NEHEN 3.0 to incorporate clinical and other patient data, aligning with technological advancements, industry changes, and regulatory requirements. This evolution seeks to streamline business processes, reduce administrative burdens, improve healthcare quality assessment, and otherwise support industry health data needs.

History

In 1994, a group of health system and health plan CIOs came together at MHDC to create the Affiliated Health Information Networks of New England (AHINE). The five main founding organizations – Brigham and Women’s Hospital, Beth Israel (now Beth Israel Lahey Health), Harvard Pilgrim Health Care (now part of Point32Health), Tufts Health Plan (also now part of Point32Health), and Lifespan Health System - recognized the need for a collaborative, cost-effective, standardized, and secure way to exchange patient information.

In 1998, AHINE became a separate organization called NEHEN (New England Healthcare Exchange Network). NEHEN was initially managed by Computer Sciences Corporation (CSC), then by the Massachusetts eHealth Collaborative (MAeHC) from 2012 until 2021 (when MAeHC ceased operations). NEHEN then merged back with MHDC, returning the organization to its original foundation.

Over the years, NEHEN evolved and adapted to the changing healthcare landscape. It has remained at the forefront of promoting interoperability, advocating for standardized data exchange protocols, and supporting innovative approaches to healthcare information technology. NEHEN has become a trusted platform for healthcare organizations in New England, fostering collaboration and enabling seamless data exchange to improve patient care.

The first version of NEHEN (NEHEN 1.0), was a client-server model with locally hosted servers in each of the member’s data centers that connected to all trading partners in the network. This model used multiple point-to-point connections at each member site, which required extensive monitoring and upkeep to ensure reliable uptime availability. A local portal could also be deployed within each participant organization that used the connectivity of the local server for its transactions. At one point, NEHEN also supported clinical transactions and ePrescribing exchange services via SureScripts using the NCPDP standards, but both services have been discontinued.

In 2015 NEHEN moved to its current architecture (NEHEN 2.0) which is a web-standards based architecture with no on-premise hardware or software components. NEHEN adopted a hub and spoke exchange model where all transactions flow through a central, cloud hosted point; each participant maintains only one connection to the central point and all trading partners are available from there. This is a far more efficient architecture than the previous design in that it eliminated the many-to-many connectivity model and removed the locally hosted components. Additionally, this model created a central point for performance monitoring, reporting, security, and other benefits the earlier design could not provide. NEHEN saw significant gains in productivity and performance once this design was moved to the cloud and processing resources could be allocated dynamically. 

NEHEN 3.0 - The Future

MHDC is now ready to move to the third incarnation – NEHEN 3.0, a cost-effective, collaborative, open, standards-based clinical and administrative data exchange, designed with automation in mind. NEHEN 3.0 will continue to provide traditional X12-based EDI exchange services at competitive pricing. NEHEN will incorporate clinical data exchange standards and technologies, including the more modern and powerful HL7® FHIR® application programming interfaces (APIs). Support for multiple technologies and shared data and transaction standards will enable NEHEN 3.0 to offer consistency and a single point of entry for all data exchange needs. To meet these challenges, NEHEN 3.0 will: 

1. Update existing X12 EDI services to offer the best overall value.
2. Incorporate core FHIR support and the related infrastructure components such as identity management, endpoint routing, security, provenance management, code mapping and translation, and other required support services. This includes conversion between X12 and HL7 FHIR for prior authorization, referrals, and other necessary transaction types with HIPAA-mandated X12 requirements.
3. Automate key FHIR-based exchange use cases – initially prior authorization and quality measures exchange - using the core NEHEN infrastructure. We will adopt other use cases and workflows as we move forward in an iterative advancement model, as determined by our collaborative governance process.
4. Offer NEHEN-operated features supporting each use case for users who do not want to perform independent backend processing.

On October 6, 2023, MHDC released a Request for Proposal (RFP) for NEHEN 3.0, seeking vendors capable of providing cutting-edge solutions for X12, FHIR, electronic prior authorization, or quality measures. 

MHDC is seeking a long-term service-model delivery relationship with vendors who will embark on a multi-year journey with us and our community, to be selected by the end of February 2024. Check our NEHEN 3.0 website for updates.