Where does the government’s NHIN strategy fall on the political and economic spectrum of alternative approaches to health care policy?
NHIN
Where does the government’s NHIN strategy fall on the political and economic spectrum of alternative approaches to health care policy?As for the political ramifications, I see these as the major roadblocks:
Cost containment: Interoperable EMR systems have the potential to eliminate waste and duplication of effort, streamline workflow, increase productivity, and slow health care inflation.
Quality: The 2001 Institute of Medicine Report Crossing the Quality Chasm identified five activities in which the use of health IT has been demonstrated to improve the quality of patient care: (1) researching treatment alternatives or recommended guidelines; (2) sharing clinical data and images; (3) reviewing patient notes, lists of medications, and lists of problems; (4) creating reminders for preventive care; and (5) writing legible prescriptions.
Patient empowerment: Medical practice is moving toward patient-centered care. When knowledgeable patients are actively involved in self-management and decision making, outcomes can improve along with patient satisfaction. Many cost-containment strategies also rely on patient involvement, which is enhanced by access to one’s own EHR.
Data: The fourth argument for EMRs is simply to improve the quality and quantity of data that can then be used for a variety of purposes. “Trying to create an accountable system or a well-functioning health care marketplace without accurate, accessible, meaningful, and timely date is an exercise in futility” (Halvorson, 2005, p. 1266).
these above are from the document provided:
Case 8-1 REGIONAL HEALTH INFORMATION ORGANIZATIONS (RHIOs): DISRUPTIVE TECHNOLOGY OR BUSINESS AS USUAL?
HIT provides an opportunity for insights into why and how the health industry remains so far behind others in the adoption of new information technologies, despite leadership and motivation for change. Entrepreneurial vendors abound. Influential politicians and professionals call for change, and the public wants it; however, this potentially disruptive set of innovations continues to sputter and lurch forward, often threatening to stall. This case contrasts two approaches to community-wide health information and communication networks.
â?¢ â?¢The first approach is the Whatcom Health Information Network (HINET), a grassroots, community-based, community-initiated, distributed model that links physician practices, the local hospital, and other providers of health-related services. This network dates to the early 1990s.
â?¢ â?¢The other approach is the NHINâ?”the federal government’s recent attempt to exert market-oriented technological leadership, including the encouragement of demonstration projects of RHIOs. This national strategy seems to favor a more top-down, centralized model and has tended to emphasize extending the reach of complex, large-scale, dedicated systems used by large hospitals and integrated health care systems.
These two approaches are not mutually exclusive and, indeed, have significant overlap. Much of the value of the Whatcom Health Information Network stems from the fact that it gives providers online access to EMRs stored at the local hospital. HINET is an example of a RHIO, and the federal NHIN strategy is designed to support RHIOs. Community networks similar to HINET participate in the four teams the Office of the National Coordinator for Health Information Technology (ONCHIT) assembled to develop regional models that might serves as models for a national system.
The approaches are, nonetheless, different in several ways. One attempts to deploy emerging products from a wide set of vendors in a manner that is responsive to the capacity and cost requirements of smaller practices and the local community. The other represents an attempt to speed up the agonizingly slow and often disappointing development process for large-scale technologies first attempted with time-shared systems in the late 1960s.
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