Current Federal Government Initiatives - Essay Example

Three existing models are used to connect these communities of networked information; hybrid, co-op, and federation.
Federation combines enterprises that are self-sufficient and maintain an agreement to share and network and allow access to information via a peer-to-peer system. Co-op combines enterprises that are comprised of smaller enterprises using a combined data repository that shares their technology and expenses. Hybrid is a combination of the two which is more beneficial in larger areas where information is shared across geographical areas. Many are formed originally as non-profit and once established change to a profit status.

Creating a health information network that is national should be centralized, available on the internet, governed by both public and private organizations, and patient-centered, complying with all health information security protocols and standards. Cooperation between government and the public sector is essential and regional-level networks need to include harmonization (Conn). Uses of health information can include quality assurance, clinical pathways, protocol development, outcome measurements, health plan performance, and underwriting among many other attributes. A health information system can be used by patients, providers, case managers, drug manufacturers, insurance companies, and other payers.

Despite technological advances in healthcare, electronic solutions continue to lag behind other areas in information technology. Electronic personal health care records allow patients to store, view, capture, and share information about their health care needs. They are a combination of data, knowledge, and software tools that allow consumers to become more active in their case management. A 2009 survey indicated that 8 of 10 Americans are concerned about their health care data being used inappropriately (McGee). Medical costs are increasing patient exposure and patients are responding by wanting more access to information about comparative costs and quality of care.

The sharing and use of data from multiple locations require data to be built upon common words, structures, and organizations. Interoperability requires that groups support common functions and procedures, and semantic interoperability requires that the language must be easily understood by a computer database system (Hammond). The Institute of Medicine has developed standards to retain patient safety in data sharing operability. Standard classes include electronic health records, knowledge representation, application level support, and data interchange and data components.

Examples include RIM, data elements, guidelines and protocols, syntax, web services, security, and clinical document architecture (Hammond). Organizations responsible for developing and maintaining these standards include the Accredited Standards Committee, Integrating the Healthcare Enterprise, Health Level Seven, The American Dental Association, and Digital Imaging and Communication in Medicine. These organizations each develop different standards in different areas such as imaging requirements, security and privacy standards, distance learning, and prescription messaging.

Standards must be well defined and must conform to standardized medical technology. Billing codes include ICD9 and ICD10, the Food and Drug Administration set standards for dosage forms and packaging routes, product labeling is structured and CPT codes define standard terminology for procedures. Health Level Seven defines terms not defined elsewhere. More clinical specialists are becoming involved, creating opportunities and scenarios that define potential use which helps in the process the creating new systems and data sets with which to work.

The Office for the National Coordinator for Information Technology was established in 2004 to coordinate IT expenses, encourage the creation of new National health information networks and promote the creation of local facilitation of clinical data exchange while encouraging the growth of regional health information networks (Halamka). Clinical practices involved implementing the ability to view clinical data among practitioners and began to offer writing capabilities to clinicians who previously had only readability.
Handwritten orders were nearly eliminated in some facilities and new systems have reduced errors by 90% and by half overall in other areas. Inpatient records are completely automated in many locations and from 2005 forward no records were received by Physicians for the wrong patient. Data shared among providers results in error reduction and higher quality care through access to all available patient information.

The creation of a Regional Health Information Network involves recognizing what needs improvement, what data should be available, and to whom. A startup requires deciding on organizational structure and locating sources of possible funding. Transition and production phases involve beginning the technical project planning, beta, and pilot testing, and processing of data between multiple channels and once the project reaches maturity new partners and initiatives can be developed.

Infrastructure will function in one of two ways, utility and neutral. The utility serves as a clearinghouse database for patient information and is easy and quick to implement. A neutral or facilitator functions through the process of bringing together competitor enterprises, bridging multiple locations, and attempts to use an open standards policy, allowing standards from all areas to be applied, a fairly complex networking system. Usually, these networks are much more difficult to implement though once they are established the open standards policy makes it easy for organizations and vendors to participate. Read More