Current Activities

Consistent with our mission to address the legal, policy, and technical barriers that inhibit health information exchange between entities within a state and across states, NATE participates in a number of ongoing and emerging projects in the HIE domain.  Current projects include the following:

NATE Blue Button for Consumers (NBB4C) Trust Bundle

The flagship NATE Blue Button for Consumers (NBB4C) Trust Bundle contains trust anchors of consumer-facing applications that utilize Direct to securely move data from one application to another. The NBB4C Trust Bundle helps relying parties to identify consumer facing applications (CFAs) that meet or exceed criteria considered to be the most important characteristics of a trustworthy steward of consumer health information, while still enabling patients to benefit from the value of having access to their health information.

Participation in the NBB4C Trust Bundle facilitates secure exchange of health information from provider-controlled applications to consumer-controlled applications such as personal health records (PHRs) using Direct secure messaging protocols. Provider organizations that wish to send messages to consumers using one of these recognized applications should load this bundle. In most cases, PHRs that are onboarded to the NBB4C have loaded publicly recognized trust bundles of provider facing applications and Direct messages should be enabled.


Onboarding applications and supplementary documentation should be submitted through the NATE Bundles Administrator at

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CMS Blue Button on FHIR Pilot Project

NATE and the Blue Button on FHIR team at the Centers for Medicare and Medicaid Services (CMS) are working together to collaboratively establish a trust mechanism for consumer-facing applications (CFAs) that wish to access CMS beneficiary data via APIs. As part of the Blue Button on FHIR pilot, NATE is extending its administrative tools and governance processes to help demonstrate how CMS (and potentially other data holders with APIs designed to disclose PHI to an application chosen by a consumer) can leverage the private sector’s existing trust communities without building isolated and duplicative government-administered communities.

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Emerging Innovations in Personal Privacy Management and eConsent

Kantara Initiative and NATE are collaborating to develop a series of educational programs for stakeholders. This series, slated to begin in 2016, will focus on emerging standards driven innovations related to the management of personal privacy preferences, electronic authorizations for disclosure (also known as “eConsent”) and related topics such as delegation of authority.

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Virtual Clipboard Initiative

The Workgroup for Electronic Data Interchange (WEDI) and NATE have partnered to work on Phase II of the Virtual Clipboard Initiative and to advance research concerning healthcare interoperability. Building off recommendations contained in the 2013 WEDI Report, the Virtual Clipboard Initiative was developed to leverage advanced technologies to dramatically enhance the patient experience while improving patient safety.

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Get My Health Data

Consumer demand for their digital health data will position patients as equal partners in care and create fundamental change in the healthcare system. The new Get My Health Data Campaign has three goals: give consumers the information and tools they need to ask for and use their digital health data; identify and promote innovative apps and tools that help consumers securely compile, store and use their health data; and promote a culture in which consumer access to data is the rule, rather than the exception.

The Get My Health Data Campaign is a collaborative effort among leading consumer organizations, healthcare experts, former policy makers and technology organizations working to enhance consumer access to digital health information. NATE is proud to be a Collaborator with the Get My Health Data Campaign.  Check out more information and see how you can help at

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Flip the Clinic

Flip the Clinic, a project of the Robert Wood Johnson Foundation, is collaborating with more than 160,000 clinicians and staff practicing at sites across the United States, who have pledged to inform patients about their right to get digital copies of their medical records. Flip the Clinic will work hand-in-hand with clinicians at these sites to redesign how clinicians respond to patients’ requests for their own records, with the goal of making health-information access, sharing, downloading, and use a more seamless experience for both patients and clinicians. Flip the Clinic is further committing to educate patients about the President’s Precision Medicine Initiative and how to get involved.

NATE will bring the expertise of its members and community – including nationally recognized domain experts and experienced real world implementers – to assist each Flip Team in selecting the optimal approach to providing consumers with access to their health information, given that Team’s current capabilities and stage on the sharing maturity continuum. NATE’s leadership is committed to supporting Flip the Clinic‘s goals of making health information accessible to consumers, empowering them to make their own decisions about when and with whom their data is shared. NATE’s immediate goal as a supporter of this Flip will be to help reduce the frustration for those consumers and clinicians involved in the project by providing focused recommendations and useful education about the options available to achieve the objectives of Flip the Clinic #55.

Flip the Clinic #55 collaborators include: 504 Health Net, Allergy and Asthma Care Centers, Almost Family, Austin Diagnostic Clinic, Children’s Integrated Center for Success, Epic, Inova Health, Johns Hopkins Sibley Memorial Hospital, LIVESTRONG Foundation and Cancer Institutes, MU Health Care, National Association for Trusted Exchange, Palo Alto Medical Foundation, text4baby, Trinity Health, and UNC Health Care.

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Exciting Cross-Border Partnership with MaRS Discovery District

NATE has established a  Memorandum of Understanding (MoU) with MaRS Discovery District in Toronto to collaborate on projects that accelerate access to, and personal use of, healthcare data by patients in the United States and Canada. This collaboration will involve a number of projects and initiatives related to health data liberation.

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Become a Member of NATE

NATE’s members include local and federal government entities, corporations, associations and individuals.


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NATE’s PHR Community

NATE is building a community to expand upon the current NBB4C Trust Framework.  NATE members encourage all stakeholders with an interest in the next phase of NATE’s activities around patient controlled exchange to subscribe here.


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