In 1,000 to 1,250 words, briefly describe each of the following terms and their
ID: 460476 • Letter: I
Question
In 1,000 to 1,250 words, briefly describe each of the following terms and their relationship to each other: Community health information network (CHIN) Regional health information organization (RHINO) National health information network (NHIN) Health Information Technology for Economic and Clinical Health Act (HITECH Act) Once you have defined the terms and their relationship to each other, explain their relationship to the development of a patient-centered management system and electronic health records (EHRs).
You are required to use three qualified references
Explanation / Answer
Community health information network (CHIN)
A community health information network (CHIN) provides technology-based information services to help maintain optimal health for all the residents of a community. Defining features of a CHIN are that its services are available to all stakeholders and that competitors collaborate to share information. The initial impetus for a CHIN is usually to facilitate paying for health care or to share clinical records. Complex legal, organizational, funding, and control issues confront CHIN initiators, and reliable models do not exist today. During development, issues of program focus and technology selection arise, followed by concerns about information privacy and the CHIN's role in quality of care. Once basic capabilities are implemented, a mature CHIN can offer extensive cost-recovering health-related services to providers, related agencies, and consumers. Developments are underway that eventually will allow a CHIN to support a fully integrated longitudinal health record. A national network of mature CHINs would offer health care professionals further collaborative possibilities that could change the shape of future health care.
A Community Health Information Network (CHIN) is a web-based net of computer systems which allows the electronic exchange of clinical, financial and administrative information among unaffiliated healthcare entities in order to improve the efficiency and delivery of healthcare in the community. It achieves this through a combination of services, products and technology.
One field of application in which CHINs can be very effective is disease management; the aim of disease management is to align patient, provider and payer interests in order to enhance quality of care and cost savings. CHINs can be used to effectively and efficiently implement disease management programmers through linking disease management systems (i.e. computerized disease management programmers) with other information systems. The application of CHINs in the implementation of disease management programmers has many benefits including shared data, internal communication, and external communication, value-added applications, bonding and marketing presence. However, there are also problems and pitfalls of an architectural and ‘emotional’ nature. Architectural problems relate to legacy system incompatibility, legacy functionality, external data representation, communications disparity, distributed governance, flexibility versus homogeneity, confidentiality, and size and scalability. Emotional problems include personal barriers, community and ethnic cultural issues, and suspicion between the various levels of care involved in an information exchange process.
Many examples of operational CHINs can be found on the Internet. Although many challenges lie ahead for patients, healthcare providers and healthcare organizations in this field, these examples show that the use of CHINs will influence medical and healthcare practice in a positive way, especially in terms of disease management.
Regional health information organization (RHINO)
A regional health information organization (RHIO) is a type of health information exchange organization (HIO) that brings together health care stakeholders within a defined geographic area and governs health information exchange among them for the purpose of improving health and care in that community. In present form, most current efforts for health information exchange are regional health information organizations.
RHIOs typically include a range of participating health care provider entities as well as other health stakeholders such as payers, laboratories and public health departments and are often managed by a board of directors comprised of representatives from each participating organization. In order for RHIOs to be established, various stakeholders have to develop consensus on what information can be shared among different participating entities. In addition, prior to exchanging information the various entities need to sign data use agreements. Because the capacity to effectively store and manage clinical data electronically is a prerequisite for participating in health information exchange, RHIOs often have programs to assist affiliated providers with health IT adoption at the institutional level.
National health information network (NHIN)
The Nationwide Health Information Network (NHIN) is the critical portion of the health IT agenda intended to provide a secure, nationwide, interoperable health information infrastructure that will connect providers, consumers, and others involved in supporting health and healthcare. The NHIN will enable health information to follow the consumer, be available for clinical decision making, and support appropriate use of healthcare information beyond direct patient care so as to improve health.
Applications:
The Office of the National Coordinator is advancing the NHIN as a ‘network of networks,” built out of state and regional health information exchanges (HIEs) and other networks so as to support the exchange of health information by connecting these networks and the systems they, in turn, connect.
In its first year, the NHIN established four consortia to design and evaluate standards-based prototype architectures for the NHIN. These prototypes demonstrated the advancement of:
In addition to the prototype architectures, other significant accomplishments from the first year of the NHIN included:
Health Information Technology for Economic and Clinical Health Act (HITECH Act)
The HITECH Act outlined the intended plans for the adoption of electronic health records through meaningful use. The CMS Medicare and Medicaid EHR Incentive programs have evolved into three stages of meaningful use with their own goals, priorities, and their own final rule. Meaningful use means “providers need to show they’re using certified EHR technology in ways that can be measured significantly in quality and in quantity.”
On October 6, 2015, the Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) released final rules that simplify requirements and add new flexibilities for providers to make electronic health information available when and where it matters most and for health care providers and consumers to be able to readily, safely, and securely exchange that information. The final rule for 2015 Edition Health IT Certification Criteria (2015 Edition) and final rule with comment period for the Medicare and Medicaid Electronic Health Records (EHRs) Incentive Programs will help continue to move the health care industry away from a paper-based system, where a doctor’s handwriting needed to be interpreted and patient files could be misplaced.
Explain their relationship to the development of a patient-centered management system and electronic health records (EHRs).
Two of the most important developments in ambulatory practice over the past 20 years are the advent of patient and relationship-centered care (PRCC) and electronic health records (EHRs). However, there is a large gap in knowledge and practice between PRCC and EHR use. We believe the integration of PRCC with EHRs has the potential to personalize care, improve population-based care, and increase patient involvement. To accomplish this, advanced practitioners from both computer- and communication-centric disciplines must work together to establish systems that work synergistically. Research examining how outstanding clinicians use EHRs is essential to establish best practice models of use. As well, clinicians must examine how they use EHRs in their communication with patients, become aware of when the EHR hinders the human connection and when it enhances it, and develop a repertoire for using it simultaneously with PRCC.
We believe that there is a great potential for PRCC and the EHR to become synergistic, adding to one another rather than being in a zero sum relationship.