NHIN Timeline: Documenting the history and development of the National Health Information Network

This is an annotated timeline documenting the activities of the National Health Information Network. Related documents, when available, are linked. Additional source documents follow the timeline.



February 17, 2009: ARRA, otherwise known as the Obama Stimulus Bill, is signed into law. The bill contains numerous provisions relating to healthcare IT, the Office of the National Coordinator, and other NHIN-related issues. The text of the legislation is here. CalOHI has posted a helpful summary of the provisions of ARRA here.



December 15-16, 2008: The 5th NHIN forum will be held in Washington DC. The forum will present progress reports from the NHIN trial implementation projects. HHS NHIN page.

Fall 2008: The new private “non-representational” AHIC board is in place. The new board includes representatives from Eli Lilly and Wal Mart, among others. Several articles are available about the transition:

  • Healthcare IT NewsJune 30, 2008 Article discussing controversy over funding of the AHIC successor due to funds coming from group membership fees of $1,000 – $100,000.

September 23, 2008: The NHIN trial implementation projects are set to be demonstrated in September in Washington D.C. at the planned AHIC meeting. Meeting details: AHIC.

September 23, 2008: Stakeholders left behind……. AHIC successor names board: press release. The new AHIC notes that the “Board of AHIC successor did not recommend that the Board be representational.” The AHIC board is decidedly not representational, in particular, privacy interests are not represented on this board. This is something the World Privacy Forum warned expressly about in terms of credibility of the new AHIC. See the WPF comments urging AHIC to be constructed fairly.

July and August: AHIC successor call for board nominations. See the main AHIC Successor site or the board nominations announcement.

April 30-May 2, Joint forum, NHIN – HISPC- SLHIE. This joint forum was held in Dallas Texas. The powerpoints are by and large online as of Aug. 2008. See the NHIN forum web site for the links to the slides and other conference information.

March 12: The Centers for Disease Control (CDC) awards three contracts for NHIN development. The focus is on biosurveillance. (Article)

March: The “DURSA” (Data Use and Reciprocal Support Agreement) Workgroup slated to complete data use of reciprocal support agreement for NHIN test data. The only public information is available on a slide located here. The DURSA workgroup is one of the NHIN cooperative workgroups.

February 26: 20 Federal agencies to build a mini-NHIN for government, the NHIC-Connect Gateway. (article)

January – March: HHS establishes its NHIN “Cooperative workgroups” meetings and activities. No official information beyond the names of the workgroups is publicly available, and meeting announcements are not made to the public. A brief presentation incorporating the DURSA cooperative workgroup is available here. One member of the DURSA group has been made public by the member’s organization. (Press release).



December 11-12: Fourth NHIN Conference, Long Beach, California. (Conference page) (agenda)

November 2007: ONC update to NCVHS on the NHIN trial projects. (PDF)

September 28: Press release announcing trial implementations of the NHIN (Press release)

Trial implementations of the NHIN will be taking place in 2008 in these settings:

CareSpark — Tricities region of Eastern Tennessee and Southwestern Virginia
Delaware Health Information Network — Delaware
Indiana University — Indianapolis metroplex
Long Beach Network for Health — Long Beach and Los Angeles, California
Lovelace Clinic Foundation — New Mexico
MedVirginia — Central Virginia
New York eHealth Collaborative — New York
North Carolina Healthcare Information and Communications Alliance, Inc. — North Carolina
West Virginia Health Information Network — West Virginia

August 13: AHIC successor Notice of Funding Availability published.

August 6: AHIC successor white paper published (AHIC white paper, PDF)

July 2007: CCHIT Certified Ambulatory EHRs: most recent list of certified Ambulatory EHR products (CCHIT)

May 31: HHS publishes its analysis of the NHIN prototypes. The 113-page analysis was prepared by Gartner (Read the Analysis). In the 113 pages, privacy was not clearly defined, and received little substantive discussion.

March: CCHIT Certified Ambulatory EHR criteria is final for 2007 (CCHIT standards)

March 5, 6 HISPC National Meeting for Office of National Coordinator’s States Privacy & Security Contract. See meeting materials (RTI)

January 26 State Alliance for eHealth has first meeting (HHS, NGA)

January 25, 26: NHIN prototypes demonstrated live in Washington D.C. The powerpoint presentations that accompanied some of the demonstrations are now available online: NHIN live demos and prototypes.

January 23 RHIO extension report, available here

Planned:  Certification process for the hospital-based electronic health records systems in place. Some certifications are in place as of 2007. See http://www.hhs.gov/healthit/product/ for certifications. See also http://www.globalhealth.gov/EhealthITRemarksInteroperabilityMalagaSpain4-10-06.pdf for comments about this initiative. (Source: remarks of Alex M. Azar II Deputy Secretary, U.S. Department of Health and Human Services Address to European Union Health Ministers eHealth 2006 High-Level Conference and Exhibition Málaga, Spain April 10 2006)



October 16, 17 NHIN conference #2, presentations available (HHS)

September RHIO report issued; “best practices” state level health information exchange report and website for project

Summer Creation of AHIC workgroup on Confidentiality, Privacy and Security (HHS).

June 28, 29 Scheduled: First nationwide health information network forum. Identification of NHIN functions.

First Nationwide Health Information Network Forum; National Institute of Health’s Natcher Conference Center in Bethesda, MD


May 23 Multiple NHIN-related contracts awarded


“The U.S. Department of Health and Human Services (HHS announced today that 22 states and territories have entered subcontracts with RTI International, Inc. “

May 17 American Health Information Community Approves First Set of Recommendations

“The American Health Information Community (the Community) unanimously approved and delivered 28 recommendations yesterday to HHS Secretary Mike Leavitt for his consideration. The Community made recommendations on how to make health records digital and interoperable while protecting patient privacy and the security of those records.” http://www.hhs.gov/news/press/2006pres/20060517a.html

April 20 David Brailer resigns

April 6 David Brailer testimony updating NHIN progress

March Federal Health Architecture realigned. http://www.hhs.gov/fedhealtharch/

“To better meet the President’s health IT goals, FHA as of March 2006 has been realigned to provide the federal perspective using the processes created within ONC to ensure that interoperability exists within and between the public and private sector. FHA will achieve this refined vision by providing input into the established infrastructure and guidance for implementation within the public sector. Moving forward, FHA will be representing and coordinating the federal activities in all matters relating to the President’s health IT plan.” See http://www.hhs.gov/asl/testify/t060406a.html.



November 29 Second AHIC meeting http://www.hhs.gov/healthit/m20051129.html

November 10 HHS Awards Contracts to Develop Nationwide Health Information Network. Some contract information available at: http://www.hhs.gov/healthit.

October 7 First American Health Information Community meeting


October 6 Three contracts awarded totaling $17.5 million. Contracts are for creating standards, compliance certification process, and for analyzing state medical laws. http://www.hhs.gov/news/press/2005pres/20051006a.html

“The Department of Health and Human Services (HHS) today awarded three contracts totaling $17.5 million to public-private groups that will accelerate the adoption of health information technology (health IT) and the secure portability of health information across the U.S. These groups will form strategic partnerships to develop the building blocks necessary for achieving the President’s goal of widespread adoption of interoperable electronic health records (EHR) within 10 years.”

ALSO October 6: AHRQ Awards Over $22.3 Million in Health Information Technology Implementation Grants:http://www.hhs.gov/news/press/2005pres/20051006.html

September 13 American Health Information Community Commissioners selected http://www.hhs.gov/healthit/ahic.html

July 14 Secretary Leavitt announced the formation of a national public-private collaboration, the American Health Information Community, a public-private body formed pursuant to the Federal Advisory Committee Act. The Community has been formed to facilitate the transition to electronic health records in a smooth, market-led way. Call for nominations: http://www.hhs.gov/news/press/2005pres/20050714.html

June 6 Request for Proposals
“Secretary Leavitt Takes New Steps to Advance Health IT
National Collaboration and RFPs Will Pave the Way For Interoperability”


June 3 HHS report on Nationwide Health Information Network (Exchange) (Summation of RFI comments) Report is available here:http://www.hhs.gov/healthit/rfisummaryreport.pdf.

May 11 National Coordinator released the Health Information Technology Leadership Panel Report, prepared by the Lewin Group.

Final report: www.hhs.gov/healthit/HITFinalReport.pdf . See also http://www.hhs.gov/healthit/sechitlp.html

April 26 Indian Health Service shares EHR system with NASA .


February 15 HHS Request for Information on NHIN due.

Original Federal Register Notice: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2004_register&docid=DOCID:fr15no04-78



November 15 RFI published by HHS on NHIN “Development and Adoption of a National Health Information Network.”

Federal Register Notice: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2004_register&docid=DOCID:fr15no04-78

October 13 $139 million in contracts awarded by HHS to adopt health care technology.

HHS Awards $139 Million to Drive Adoption of Health Information Technology


July 21 HHS issued its “Strategic Framework: The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care,” (The Framework) released at the Secretarial Summit on Health Information Technology at the Washington Convention Center.

Thompson Launches “Decade of Health Information Technology”
Strategic Report Outlines Steps to Implement Widespread Adoption of Electronic Health Records and New Nationwide Interoperable Health Information Network

The Framework outlined an approach toward nationwide implementation of interoperable EHRs and in it we identified four major goals. These goals are: 1) inform clinical practice by accelerating the use of EHRs, 2) interconnect clinicians so that they can exchange health information using advanced and secure electronic communication, 3) personalize care with consumer-based health records and better information for consumers, and 4) improve public health through advanced bio-surveillance methods and streamlined collection of data for quality measurement and research.” (Statement of David J. Brailer, M.D., Ph.D. National Coordinator for Health Information Technology U.S. Department of Health and Human Services, Thursday, June 30, 2005.)

May 6 First National Coordinator of Health Information Technology named

Secretary Thompson, Seeking Fastest Possible Results, Names First Health Information Technology Coordinator (David J. Brailer, M.D., Ph.D. named).

April 27 Executive Order 13335 signed by President George Bush

Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator

April 26 Health initiative unveiled.

Remarks by the President at American Association of Community Colleges Annual Convention, Minneapolis, Minnesota.

March 22 Federal Health Infrastructure established to create interoperability and increase efficiency within the public sector. See http://www.hhs.gov/asl/testify/t060406a.html

January – April 2004

President’s Health Information Technology Plan (Chapter 3 of the plan)


Other documents of interest:

Timeline notes:

This timeline will be updated as necessary on a regular basis.

Sourcing notes:

The primary sourcing for this document are materials released by Health and Human Services and other relevant U.S. Government agencies, contractors, and the remarks of federal employees speaking on the record. When available, sources are hyperlinked from this document.


Original publication date: June 5, 2006.

Last update: October 3 2008.

Author: Pam Dixon