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Health IS/IT Components: The components of HMIS and how they interface with one another.

Health IS/IT Components: The components of HMIS and how they interface with one another.

identify the components of HMIS and how they interface with one another.

An effective digital health ecosystem relies on a broad spectrum of technical, clinical, and administrative stakeholders to gather and analyze patient data and then use that information to improve the quality of care offered. Within the health care environment, information systems and technology (IS/IT) are used to ensure patient privacy and security, inform optimal decision making, and assist in operational efficiency, which further enhances the services that clinicians, hospitals, technology developers, researchers, and policymakers are able to provide.

Boosting patient basic safety needs a lot more than systems for revealing and analyzing occasions mistakes needs to be avoided from happening in the first place. Several effective tools are available that can assist in the prevention of adverse events. Clinical decision support systems (CDSSs), such as those for medication order entry, can prevent many errors from occurring (Bates et al., 1997, 1998, 1999). Computer-based reminder systems can facilitate adherence to care protocols (Balas et al., 2000); computer-assisted diagnosis and management programs can improve clinical decision making at the point of care (Durieux et al., 2000; Evans et al., 1998); and immediate access to clinical information, such as results of laboratory and radiology tests, can reduce redundancy, allowing for more efficient decision making. Incorporation of new research findings into clinical practice is also important for improving patient safety. Balas and Boren found that it takes an average of 17 years for research to reach clinical practice, whereas newer technological innovations take an average of 4 to 6 years. Actionable knowledge representation through the use of information systems holds promise for better connecting clinical research and patient care practices (Balas and Boren, 2000). In addition, the Internet can be used for customized health education for patients, thereby promoting more effective self-management of chronic and other medical conditions (Cain et al., 2000; Goldsmith, 2002). The Internet can be used as well for communication among all authorized members of the care team (e.g., primary care providers, specialists, nurses, pharmacists, home health aides, the patient, and lay caregivers), a capability that is especially important for the chronically ill. The capabilities provided by these clinical information systems cannot be achieved, however, without standards-based interoperability founded on the national health information infrastructure (NHII).

The NHII is described as a selection of techniques, standards, apps, systems, principles, and lawful recommendations that help all areas of personalized health, health care, and open public wellness (Nationally Committee on Crucial and Well being Info, 2001). It encompasses an information network based on Internet protocols, common standards, timely knowledge transfer, and transparent government processes with the capability for information flows across three dimensions: (1) personal health, to support individuals in their own wellness and health care decision making; (2) health care providers, to ensure access to complete and accurate patient data around the clock and to clinical decision support systems; and (3) public health, to address and track public health concerns and health education campaigns (National Committee on Vital and Health Statistics, 2001)

Making use of the NHII, info techniques can provide the proper info, with all the appropriate time, and off off to the right men and women, enabling chance-cost-free care and helping robust protection confirming methods for circumstances where negative events and near misses do occur. The NHII also will yield many other benefits in terms of new opportunities for care access, efficiency, and effectiveness; public health; homeland security; and clinical and health services research. For example, electronic health records (EHRs), in conjunction with secure data exchange, may allow for early detection of and rapid response to infectious diseases. The NHII will also facilitate the organization and execution of large-scale inoculation programs, as well as the dissemination to clinicians and patients of up-to-date information and practice guidelines on the presentation and treatment of morbidity due to chemical and biological threats.

Standards-centered information techniques constructed about the first step toward the NHII will permit go across-business data discussing. Several promising public–private information technology demonstrations currently under way nationwide are exchanging data outside traditional organizational boundaries. One such project is the New England Healthcare Electronic Data Interchange (EDI) Network (NEHEN)—a consortium initiated in 1998 and led by Computer Science Corporation (New England Healthcare EDI Network, 2002). Membership is open to providers, health plans, and payers in Massachusetts and Rhode Island; there are currently 14 members, including most of the region’s largest insurers and health plans. NEHEN provides its members, who pay a flat monthly fee, with access to a secure high-speed network for sending and receiving transactions. Members can either integrate NEHEN functions directly into their own management systems or access the NEHEN network using NEHENLite, a Web-based application.

An additional guaranteeing project is the Indiana Network for Affected individual Proper care (INPC), started 10 years ago in Indianapolis from the Regenstrief Institution for Medical. Currently, all 13 acute care hospitals in the city and approximately 20 percent of the metropolitan area’s outpatient physician practices are participating (Overhage, 2003). Participating institutions pay a monthly fee for access to selected electronic information that forms the basis for an “operational community-wide electronic medical record” that includes reports from emergency room visits, laboratory results, admission notes/discharge summaries, operative reports, radiology reports, surgical pathology reports, inpatient medications, immunizations, and a tumor registry (Overhage, 2003). Each health care provider retains its patients’ information in its organization’s database; however, selected information in those datasets can be shared among organizations through use of a Global Patient Index (Overhage, 2003). INPC not only allows for the secure storage and exchange of clinical information but also provides clinical decision support and public health surveillance and reporting.

A third illustration of a federal information exposing local community may be the Santa Barbara Area Care Information and facts Trade, established in 1998 utilizing a partnership between CareScience as well as the California Healthcare Base (CareScience, 2003). More than 75 percent of the health care providers in Santa Barbara County are participating, including medical groups, hospitals, clinics, laboratories, pharmacies, and payers. The Care Data Exchange allows for rapid and secure delivery of patient data to authorized users who have informed consent.