Reconstructing the System of Babel — A CEO’s Perspective on Health Information Transactions

Defining a Health Information Exchange

The united states is facing the largest scarcity of healthcare practitioners in our place’s history which is compounded by an rising geriatric population. In 2005 there existed one geriatrician for every 5, 000 US residents over 65 and only nine of the 145 medical Sildenax Mercado Livre schools trained geriatricians. By 2020 the is estimated to be short 200, 000 medical professionals and over a million nurses. Never, in the history of us healthcare, has so much been demanded with so few personnel. Because of this scarcity with the geriatric population increase, the medical community has to find a way to provide timely, accurate information to those who want it in a uniform fashion. Imagine if flight controllers mention the local language of their country rather than the current international flight language, English. This example captures the emergency and critical nature in our need for standard communication in healthcare. A healthy information exchange can help improve safety, reduce time hospital stays, eliminate medication errors, reduce redundancies in lab testing or procedures and make the health system faster, thinner and more productive. The aging US population along with those impacted by chronic disease like diabetes, heart problems and asthma will need to see more specialists who will have to discover a way to communicate with primary care providers effectively and efficiently.

This efficiency can only be attained by standardizing the manner in which the communication occurs. Healthbridge, a Cincinnati based HIE and one of the largest community based networks, could reduce their potential disease episodes from 5 to 8 days down to twenty four hours with a regional health information exchange. Regarding standardization, one author noted, “Interoperability without standards is like language without sentence structure. In both cases communication may be accomplished but the process is cumbersome and often ineffective. inch

United states retailers transitioned over two decades ago in order to automate inventory, sales, accounting controls which all improve efficiency and effectiveness. While uncomfortable to consider patients as inventory, perhaps it’s been the main reason for the lack of changeover in the primary care setting to automation of patient records and data. Imagine a Mom & Pop hardware store on any sq in mid America packed with inventory on shelves, ordering duplicate widgets based on lack of information regarding current inventory. See any Home Depot or Lowes and you get a view of how automation has changed the retail sector in terms of scalability and efficiency. Maybe the “art of medicine” is a barrier to more productive, efficient and better medicine. Standards in information exchange have existed since 1989, but recent interfaces have evolved more quickly thanks to increases in standardization of regional and state health information transactions.

History of Health Information Transactions

Major urban centers in The us and Australia were the first to successfully implement HIE’s. The success of these early networks was associated with an integration with primary care EHR systems already in place. Health Level 7 (HL7) represents the first health language standardization system in the united states, beginning with a meeting at the University of Philadelphia in 1987. HL7 has been successful in replacing antiquated connections like faxing, mail and direct provider communication, which regularly represent copying and inefficiency. Process interoperability increases human understanding across networks health systems to integrate and communicate. Standardization will ultimately impact how effective that communication functions just as that sentence structure standards foster better communication. The united states National Health Information Network (NHIN) sets the standards that foster this delivery of communication between health networks. HL7 is now on it’s third version which was published in 2004. The goals of HL7 are to increase interoperability, develop coherent standards, educate the on standardization and team up with other sanctioning bodies like ANSI and ISO who are also concerned with process improvement.

In the united states one of the earliest HIE’s started in Portland Maine. HealthInfoNet is a public-private partnership and is considered the largest statewide HIE. The goals of the network are to improve patient safety, enhance the standard of clinical care, increase efficiency, reduce service copying, identify public dangers more quickly and expand patient record access. The four founding groups the Maine Health Access Foundation, Maine CDC, The Maine Quality Forum and Maine Health Information Center (Onpoint Health Data) began their efforts in 2004.

In Tennessee Regional Health Information Organizations (RHIO’s) initiated in Memphis and the Attempt Cities region. Carespark, a 501(3)c, in the Attempt Cities region was considered a primary project where physicians interact directly with each other using Carespark’s HL7 compliant system as an intermediary to translate the data bi-directionally. Veterans Affairs (VA) clinics also played an important role in the first stages to build this network. In the delta the midsouth eHealth Alliance is a RHIO connecting Memphis private hospitals like Baptist Commemorative (5 sites), Methodist Systems, Lebonheur Healthcare, Memphis Children’s Clinic, Saint. Francis Health System, Saint Jude, The Regional Hospital and UT Medical. These regional networks allow practitioners to share with you medical records, lab values medicines and other reports in a extremely effective manner.

Seventeen US communities have been designated as Beacon Communities across the united states based on their development of HIE’s. These communities’ health focus varies based on the patient population and prevalence of chronic disease states i. e. cvd, diabetes, asthma. The communities focus on specific and measurable improvements in quality, safety and efficiency due to health information exchange improvements. The nearest geographical Beacon community to Tennessee, in Byhalia, Mississippi, just south of Memphis, was granted a $100, 000 grant by the department of Health and Human Services in September 2011.

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