The United States is facing the biggest shortage of healthcare practitioners in your country’s history and that is compounded by an ever increasing geriatric population. In 2005 there existed one geriatrician for each 5, 000 US residents over 65 and just nine from the 145 medical schools trained geriatricians. By 2020 the industry is estimated to become short 200, 000 physicians as well as over millions of nurses. Never, inside the history of US healthcare, has such a lot been demanded with so few personnel. Because of the shortage combined using the geriatric population increase, the medical community has to locate a method to provide timely, accurate information to people who need it in a consistent fashion. Imagine if flight controllers spoke the native language of the country instead from the current international flight language, English. This example captures the urgency and critical nature in our need for standardized communication in healthcare. The ideal information exchange may help improve safety, reduce length of hospital stays, cut recorded on medication errors, reduce redundancies in lab testing or procedures and produce the health system faster, leaner and much more productive. The aging US population along with individuals impacted by chronic disease like diabetes, cardiovascular disease and asthma will require to discover more specialists who‘ll need to find a method to contact primary care providers effectively and efficiently.
This efficiency can merely be attained by standardizing the manner during which the communication happens. Healthbridge, a Cincinnati based HIE and perhaps one of the largest community based networks, was capable of to scale back their potential disease outbreaks from 5 to 8 days right all the way down to 48 hours having a regional health information exchange. Regarding standardization, one author noted, Interoperability without standards is similar to language without grammar. In both cases communication could be achieved but the method is cumbersome and sometimes ineffective.
United States retailers transitioned over twenty years back in an effort to automate inventory, sales, accounting controls which all improve efficiency and effectiveness. While uncomfortable to consider patients as inventory, perhaps this is section of the reason to the insufficient transition inside the primary care setting to automation of patient records and data. Imagine a Mom & Pop hardware store on any square in mid America filled with inventory on shelves, ordering duplicate widgets depending on insufficient information regarding current inventory. Visualize any Home Depot or Lowes and you receive a glimpse of how automation has changed the retail sector when it comes to scalability and efficiency. Perhaps the skill of medicine is really a barrier to more productive, efficient and smarter medicine. Standards in information exchange have existed since 1989, but recent interfaces have evolved more rapidly because of increases in standardization of regional and state health information exchanges.
History of Health Information Exchanges
Major urban centers in Canada and Australia were the very first to successfully implement HIE’s. The success of those early networks was associated with an integration with primary care EHR systems already set up. Health Level 7 (HL7 ) represents the very first health language standardization system inside the United States, beginning having a meeting in the University of Pennsylvania in 1987. HL7 is capable of replacing antiquated interactions like faxing, mail and direct provider communication, which frequently represent duplication and inefficiency. Process interoperability increases human understanding across networks health systems to integrate and communicate. Standardization will ultimately impact how effective that communication functions similarly that grammar 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 is third version that was published in 2004. The goals of HL7 are to extend interoperability, develop coherent standards, educate the industry on standardization and collaborate along with sanctioning bodies like ANSI and ISO that are also worried about process improvement.
Inside the United States perhaps one of the earliest HIE’s started in Portland Maine. HealthInfoNet is really a public-private partnership and it is believed as being largest statewide HIE. The goals from the network are to enhance patient safety, enhance the quality of clinical care, increase efficiency, reduce service duplication, identify public threats 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 also the Tri Cities region. Carespark, a 501 (3 ) c, inside the Tri Cities region was considered a direct project where clinicians interact directly with one another using Carespark’s HL7 compliant system being an intermediary to translate the data bi-directionally. Veterans Affairs (VA ) clinics also played a crucial role in the first stages of building this network. Inside the delta the midsouth eHealth Alliance is really a RHIO connecting Memphis hospitals like Baptist Memorial (5 sites ), Methodist Systems, Lebonheur Healthcare, Memphis Children’s Clinic, St. Francis Health System, St Jude, The Regional Medical Center and UT Medical. These regional networks allow practitioners to talk about medical records, lab values medicines along with other reports inside a more efficient manner.
Seventeen US communities happen to be designated as Beacon Communities over the United States based on the development of HIE’s. These communities’ health focus varies driven by patient population and prevalence of chronic disease states i. e. cvd, diabetes, asthma. The communities concentrate on specific and measurable improvements in quality, safety and efficiency because of health information exchange improvements. The closest geographical Beacon community to Tennessee, in Byhalia, Mississippi, just south of Memphis, was granted a $100, 000 grant from the department of Health and Human Services in September 2011.
A healthcare model for Nashville to emulate is located in Indianapolis, IN depending on geographic proximity, city size and population demographics. Four Beacon awards happen to be granted to communities in and around Indianapolis, Health and Hospital Corporation of Marion County, Indiana Health Centers Inc, Raphael Health Center and Shalom Health Care Center Inc. Additionally, Indiana Health Information Technology Inc has received over 23 million dollars in grants with the State HIE Cooperative Agreement and 2011 HIE Challenge Grant Supplement programs with the federal government. These awards were driven by following criteria : 1 ) Achieving health goals through health information exchange 2 ) Improving long-term and post acute care transitions 3 ) Consumer mediated information exchange 4 ) Enabling enhanced query for patient care 5 ) Fostering distributed population-level analytics.
Regulatory Facets of Health Information Exchanges and Healthcare Reform
The department of Health and Human Services (HHS ) is that the regulatory agency that oversees health concerns for many Americans. The HHS is divided into ten regions and Tennessee is section of Region IV headquartered from Atlanta. The Regional Director, Anton J. Gunn is that the first African American elected to function regional director and brings an abundance of experience to his role depending on his public service specifically regarding underserved healthcare patients and health information exchanges. This experience will serve him well as he encounters societal and demographic challenges for underserved and chronically ill patients through the entire southeast area.
The National Health Information Network (NHIN ) is really a division of HHS that guides the standards of exchange and governs regulatory facets of health reform. The NHIN collaboration includes departments such as the Center for Disease Control (CDC ), social security administration, Beacon communities and state HIE’s (ONC ). 11 The Office of National Coordinator for Health Information Exchange (ONC ) has awarded $16 million in additional grants to encourage innovation in the state level. Innovation in the state level will ultimately result in better patient care through reductions in replicated tests, bridges to care programs for chronic patients leading to continuity and lastly timely public health alerts through agencies such as the CDC based for this information. 12 The Health Information Technology for Economic and Clinical Health (HITECH ) Act is funded by dollars coming from the American Reinvestment and Recovery Act of 2009. HITECH’s goals are to take a position dollars in community, regional and state health information exchanges to construct effective networks that connected nationally. Beacon communities and also the Statewide Health Information Exchange Cooperative Agreement were initiated through HITECH and ARRA. To date 56 states have received grant awards through these programs totaling 548 million dollars.
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