As the United States moves toward the goal of a secure nationwide health information network (NHIN), a new study from the Regenstrief Institute provides a framework for evaluating the costs, effort and value of what is sometimes referred to as the health internet.
The study, which appears in the May/June 2010 issue of Journal of the American Medical Informatics Association, also reports on the initial assessment of that framework by health information exchange experts across the nation.
"This work is important, because the framework will help those engaged in health information exchange around the country measure the value of NHIN services to patients and health-care providers as well as to the national health-care reform goals of quality, safety, cost and efficiency," said the study's first author Brian Dixon, M.P.A., a Regenstrief program manager and a doctoral candidate in health informatics at the Indiana University School of Informatics at Indiana University-Purdue University Indianapolis.
The Regenstrief framework also will help the nation track the development and utilization of health information exchange and the array of NHIN services currently under development with support from the Office of the National Coordinator for Health Information Technology (ONC) and U.S. Department of Health and Human Services (HHS).
"Historically novel health care information technologies have been underutilized, restricting their impact on quality of care and patient safety. This new framework will help policymakers understand its value not only in terms of quality and safety but also how widespread data exchange is being used in clinical practice. This will help answer the question of whether the national health information network envisioned by the federal government is a bridge to nowhere or a public utility that is making a difference in improving health care," said Dixon.
Regenstrief created and operates the Indiana Network for Patient Care (INPC), one of the highest volume health information exchanges in the United States. The INPC daily handles approximately 2.5 million secure transactions of clinically relevant data such as laboratory test results, medication and treatment histories, and other clinically important information in a standardized, electronic format. This information is critical to diagnoses, treatment and referral decisions. The INPC membership includes hospitals, physician practices, clinical laboratories, radiology centers, as well as rehabilitation and long term care facilities throughout Indiana.
"The new Regenstrief framework will help health information exchange developers and researchers improve efforts to measure the value that these services provide their members and communities. Locally, we will use the framework to measure how the INPC and the NHIN provide value to Hoosiers in terms of quality, safety, cost and efficiency. We hope the framework can serve as a catalyst for other communities as well to perform similar evaluations of health information exchange," said J. Marc Overhage, M.D., Ph.D., director of medical informatics at the Regenstrief Institute, Regenstrief Professor of Medicine at the Indiana University School of Medicine, and president and C.E.O. of the Indiana Health Information Exchange
A framework for evaluating the costs, effort, and value of nationwide health information exchange. Brian E. Dixon, Atif Zafar, J. Marc Overhage. JAMIA 2010 17: 295-301