Halamka: How to build a long distance service for healthcare

To Dr. John Halamka, co-chairman of the Health IT Standards Committee, the nationwide health information network (NHIN) is a kind of long distance carrier, with health information exchanges in the role of connecting people via local phone exchanges.

“Generally healthcare information exchange is local,” he wrote recently in his blog, “Life as a Healthcare CIO.”

“Hospitals, labs, pharmacies, clinician offices, and public health in a region exchange data for a specific purpose. Privacy and data use concerns are resolved locally.”

“I do not believe that an architecture that requires a monolithic central database in the basement of the Whitehouse is going to be acceptable to stakeholders.”

Halamka listed several success factors for the NHIN, including governance via a NHIN framework for policy and technology, mostly likely orchestrated by the HIT Standards Committee could serve this purpose.

NHIN development would also require education and promotion. The Office of the National Coordinator for Health IT could do this or partner with health IT organizations, such as the National eHealth Collaborative or the e-Health Initiative, he said.

Incentives related to meaningful use would encourage health information exchange, as well as a desire to access federal stakeholders, including, CDC, SSA, and FDA, and CMS via electronic health record systems.

Ideally, EHRs, HIEs, and the NHIN should use the same standards for data transport, content and vocabularies to assure that they can easily integrate regional and national information efforts, he wrote.

And, to gain the trust of consumers,  healthcare organizations should agree upon “a set of security and privacy rules, including data use and reciprocal support agreements to which everyone who links to the NHIN must conform,” Halamka said.

His blog is at http://geekdoctor.blogspot.com/.