National Health Information Network Research Articles

Creating a National Health Information Network: The Importance of Individual Provider Participation

Creating a National Health Information Network: The Importance of Individual Provider Participation

Regions work to exchange health information

President Bush declared a year ago that he wants the government to pave the way for “an interoperable health information technology infrastructure to improve the quality and efficiency of health care.” Such an effort takes time—the Office of the National Coordinator for Health Information Technology is reportedly sorting through some 5000 pages of suggestions for the national health information network—and not all health systems and care providers want to wait for the government. Some of these health systems and care providers envisioned communitywide or regional real-time exchange of patient-specific clinical information years before Bush made his intention known. At least 100 first-generation regional health information organizations (RHIOs) are in development, according to the Bush administration’s leader in health information technology, David Brailer. In fact, the RHIO that Brailer and colleagues in southern California started in 1999 is expected to be fully usable in April or May 2005, said Mike Skinner, executive director of Santa Barbara County Care Data Exchange.

Communities' Readiness for Health Information Exchange: The National Landscape in 2004

BackgroundThe Secretary of Health and Human Services recently released a report calling for the nation to create a national health information network (NHIN) that would interconnect Regional Health Information Organizations (RHIOs). These RHIOs, which others have called Local or Regional Health Information Infrastructures (LHII), would in turn interconnect local as well as national health information resources. Little data exist about the activities taking place in communities to create LHIIs. ApproachThe authors analyzed data that communities submitted in response to a request for capabilities issued by the Foundation for eHealth as part of their Connecting Communities for Better Health program using descriptive statistics and subjective evaluation. ImpressionThe authors analyzed data from 134 responses from communities in 42 states and the District of Columbia. Communities are enthusiastic about moving forward with health information exchange to create LHIIs to improve the efficiency, quality, and safety of care. They have identified significant local sources of investment and plan to use some clinical data standards but not as broadly as was expected. The communities have not yet developed the specific technical approaches or the sustainable business models that will be required. Many communities are interested in creating an LHII and are developing the leadership commitment needed to translate that interest into an operational reality. Clinical information standards can be incorporated into a community's plans as often as they need to be. Communities have to overcome funding issues, develop deeper understanding of the technical and organizational issues, and aggressively share their learning to succeed within their community and to help other communities succeed.

AAP, federal government united in plans for national health information network

Pediatricians now have a united, prominent role in helping to develop a national health information network (NHIN), following a“ groundbreaking” meeting with the key administrator of the National Health Information Infrastructure (NHII) initiative. ![Figure][1] Dr. Brailer On Dec.

AMA Urged To Make Electronic Records Policy Priority

Back to table of contents Previous article Next article Professional NewsFull AccessAMA Urged To Make Electronic Records Policy PriorityMark MoranMark MoranSearch for more papers by this authorPublished Online:21 Jan 2005https://doi.org/10.1176/pn.40.2.00400001b The electronic health record is coming to American medicine. That's what National Coordinator for Health Information Technology David Brailer, M.D., Ph.D., told physicians at the interim meeting of the American Medical Association House of Delegates last month in Atlanta.David Brailer, M.D., Ph.D., coordinates the nation's health information technology efforts. His position was created by President Bush last year.Brailer urged delegates to make adoption of the electronic health information record the number-one member services and policy priority for the AMA.“The electronic health record is the undisputed next step,” Brailer said. “When used properly in patient care, it can be therapeutic. This observation is well founded in the scientific evidence that shows that drug-drug interaction checking, allergy checking, public health surveillance, preventive care reminders, and evidence-based decision support can systematically and reproducibly improve health status, longevity, and overall care.”Brailer cited a 2003 study from the Center for Information Technology Leadership (CITL) showing that nationwide adoption of ambulatory computerized physician order entry alone could prevent more than 2 million adverse drug events and nearly 190,000 unnecessary hospitalizations each year.(CITL was chartered in 2002 by Boston-based, nonprofit Partners HealthCare System as a research organization to help guide the health care community in making more-informed technology investment decisions.)“This would save $44 billion in reduced medication, utilization, and other costs,” Brailer said. “These data demonstrate to me that the electronic health record is part of the therapeutic regimen and is indispensable to care delivery.”Brailer, who was named the most powerful person in health care today in a survey of health care leaders by the magazine Modern Healthcare, offered a vision of American medicine's future that will be shaped less by government policies and politics than by technological innovations that have transformed other aspects of the American economy.“The answer for health care is the same as it is for every other industry,” Brailer said. “Information, automation, and standardization can support the central role of the consumer and the professional.”As he noted in his address to AMA delegates, his office has oversight of more than $5 billion in health information spending by the federal government.“Our charge from the president is to restructure and align that spending to get the most value for the American people every year,” Brailer said. “We intend to change the marketplace so that [electronic health information products] are cheaper, less risky, interoperable, easier to use, and beneficial.”He was appointed to the new federal position by President George W. Bush last year and charged with achieving widespread deployment of electronic health information technology within 10 years.Brailer acknowledged the distance medicine still has to travel to achieve the promise of electronic technology. While the adoption of electronic health records by large health systems and large physician groups has been encouraging, and is becoming more commonplace, adoption by small physician groups and offices is much more problematic, he said.“I am worried about small physician offices that struggle to know which records to buy and to implement in order to get value for themselves and their patients,” Brailer said. “Without proper support, the electronic health record is just software in a computer, because the critically important improvements in process of care, decision making, and outcomes will not be realized.”And pioneers in the field of electronic health records are beset by the“ first mover disadvantage” typically confronting those who are the first to implement a new technology: they bear the costs, while those who adopt the technology later reap the benefits of those who have preceded them.Brailer outlined for AMA delegates several things his office is pursuing in order to level the playing field for small and large physician practices and speed the adoption of e-health records.Among these is the formation of a 14-member accreditation commission to help accredit and standardize electronic health record products. It will be the job of the commission to “inspect electronic health record products for functionality, interoperativity, and security,” Brailer said.The government has also encouraged the formation of Regional Health Information Organizations. “These will help organize physicians, purchasers, and hospitals to set their own fate, be free of regulation, and work toward adoption of electronic health records for their own local area,” Brailer said.He added that the government is working to encourage the development of a national health information network—what some have called “the medical Internet.”“The national health information network will allow secure, timely, useful exchange of health information between clinicians.” ▪ ISSUES NewArchived

An Examination of Infrastructures for Health Information Dissemination in the United States

The U.S. federal government has devoted substantial resources to health promotion and disease prevention research, yet there is currently no systematic published information about the infrastructures through which this research is disseminated to local levels. This article addresses that gapby using a common framework (Dynamic Network) developed by Miles and Snow to examine five national health information networks: the Regional Alcohol and Drug Awareness Resource (RADAR) Network, the Community Anti-Drug Coalitions of America (CADCA), the Children’s Safety Network (CSN), the Office on Smoking and Health’s National Tobacco Control Program (NTCP), and the Network: Addressing Collegiate Alcohol and Other Drug Issues (the Network). All of these networks include members with areas of specialized expertise, enabling them to address complex health issues. A single, federally funded entity typically functions as a broker for the networks, facilitating member communication at the national and local levels. Four of the five networks do not fund members but instead rely on a shared commitment to health promotion goals. Finally, each network is experimenting with ways of providing broad information access to their members and thus building local capacity to support healthy behaviors.

District health information systems in the public sector: health centres in Korea

The public health sector in South Korea introduced district health information systems (DHIS) in health centres in the early 1990s. DHIS aimed to help health centres to provide comprehensive health care services and to achieve effective and efficient management of their works. District health information systems are still being implemented in health centres. Information generated and collected through the systems is to be used by local authorities to plan and manage health services in their areas, and further by the central government to make a health plan and health policy at the national level. However, the adoption and implementation of DHIS by health centres does not meet the initial anticipation. Moreover, reasons for that have not been explored yet. This paper presents the development of DHIS for health centres in Korea, evaluates the project focusing on impacts and problems found in implementing the systems, and provides lessons and recommendations for establishing a nationwide health information network.

Emerging 21(st) Century Medical Technologies.

Although several medical technologies have been around since decades and are in the continuous process of development, some latest technologies are changing the way medicine would be practiced in the future. These technologies would allow medical practice from anywhere, any time and from any device. These include smart phones, Tablet PCs, Touch screens, digital ink, voice recognition, Electronic Health Records (EHRs), Health Information Exchange (HIE), Nationwide Health Information Network (NwHIN), Personal Health Records (PHRs), patient portals, Nanomedicine, genome-based personalized medicine, Geographical Positioning System (GPS), Radiofrequency Identification (RFID), Telemedicine, clinical decision support (CDS), mobile home healthcare, cloud computing, and social media, to name a few significant.

Medical Computing Programs

To the Editor:— Dr. Gabrieli's important suggestion (204:833, 1968) regarding the development of a national health information network requires some elaboration. A goal for having such a bank for information is technically feasible, however, strong forces offer resistance to the development of this important use of automated procedures. Anyone who has studied the hearings conducted by congressman Gallagher in 1966 soon becomes aware of the great fear that surrounds a discussion of a national data center. The fear is based on the loss of privacy of the individual. Since we physicians have had to report to government agencies about communicable diseases we already have the tradition of protecting the individual. There is no reason to believe that a comprehensive plan which results in a more efficient method of collecting data could not have these same safeguards for the privacy of the individual. From studies of attitudes of patients, physicians,