NHIN Direct is a project to create implementation guides and running open source prototypes which facilitate transmission.
Surescripts is partnering with Kryptiq to create a commercial product that leverages the existing e-prescribing connections in clinician offices and NHIN Direct to create a healthcare information exchange.
I believe this commercial effort is complementary and not competitive with state healthcare information exchanges and the stimulus funds given for states to accelerate interoperability.
NEHEN connects 10,000 providers in Massachusetts, but that leaves 10,000 doctors, mostly in small practices, unconnected.
Our vision is to connect every provider with every provider.
Of the unconnected providers, the majority using EHRs have e-prescribing capabilities. Connecting e-prescribing providers with the state health information exchange backbone is a win/win division of labor among NEHEN, Surescripts and other vendors.
Here's the detailed announcement of Surescripts' vision for federated, network of networks health information exchange.