NHIN & RHIO’s By Nainil Chheda www.nainil.com

NHIN - National Health Information Network National Health Information Network describes the technologies, standards, laws, policies, programs and practices that enable health information to be shared among health decision makers, including consumers and patients, to promote improvements in health and healthcare. The path to a national network of healthcare information is through the successful establishment of Regional Health Information Organizations (RHIO). Retrieved from http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=143 on February 24, 2007.

National Health Information Network describes the technologies, standards, laws, policies, programs and practices that enable health information to be shared among health decision makers, including consumers and patients, to promote improvements in health and healthcare.

The path to a national network of healthcare information is through the successful establishment of Regional Health Information Organizations (RHIO).

Retrieved from http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=143 on February 24, 2007.

Common Themes Through NHIN -- Common themes emerged regarding the nature of interoperability and health information exchange: Information must be available nationwide, in real time, wherever health care is provided (e.g., emergency room, physician’s office, hospital, laboratory). Information must be secure, exchanged in a patient-centric manner and governed by privacy and access control policies. Local or regional coordination of health information exchanges needs to support market variation.

Through NHIN -- Common themes emerged regarding the nature of interoperability and health information exchange:

Information must be available nationwide, in real time, wherever health care is provided (e.g., emergency room, physician’s office, hospital, laboratory).

Information must be secure, exchanged in a patient-centric manner and governed by privacy and access control policies.

Local or regional coordination of health information exchanges needs to support market variation.

RHIO - Regional Health Information Organization Regional Health Information Organization (RHIO) is a multi-stakeholder organization that enables the exchange and use of health information, in a secure manner, for the purpose of promoting the improvement of health quality, safety and efficiency. U.S. Department of Health see RHIOs as the building blocks for the national health information network (NHIN). When complete the NHIN will provide universal access to electronic health records.

Regional Health Information Organization (RHIO) is a multi-stakeholder organization that enables the exchange and use of health information, in a secure manner, for the purpose of promoting the improvement of health quality, safety and efficiency.

U.S. Department of Health see RHIOs as the building blocks for the national health information network (NHIN). When complete the NHIN will provide universal access to electronic health records.

What are RHIO’s

RHIO Efforts

Four Goals The four goals are: Inform clinical practice with use of EHRs. Interconnect clinicians so that they can exchange health information using advanced and secure electronic communication. Personalize care with consumer-based health records and better information for consumers. Improve population health through advanced bio-surveillance methods and streamlined collection of data for quality measurement and research.

The four goals are:

Inform clinical practice with use of EHRs.

Interconnect clinicians so that they can exchange health information using advanced and secure electronic communication.

Personalize care with consumer-based health records and better information for consumers.

Improve population health through advanced bio-surveillance methods and streamlined collection of data for quality measurement and research.

RHIO Architecture – Part 1 Federated architecture (decentralized) is an approach to the coordinated sharing and interchange of electronic information emphasizing partial, controlled sharing among autonomous databases within a RHIO. In a federated architecture, independent databases (decentralized) are connected to share and exchange information. Components in a federated architecture represent the various users, applications, workstations, main frames and other stakeholder components in a RHIO.

Federated architecture (decentralized) is an approach to the coordinated sharing and interchange of electronic information emphasizing partial, controlled sharing among autonomous databases within a RHIO.

In a federated architecture, independent databases (decentralized) are connected to share and exchange information. Components in a federated architecture represent the various users, applications, workstations, main frames and other stakeholder components in a RHIO.

RHIO Architecture – Part 2 Centralized architecture is an approach to RHIO data sharing and inter-change of electronic information emphasizing full control over data sharing through a centralized repository. Components in a centralized architecture refer to the Central Data Repository (CDR) and the requestor.

Centralized architecture is an approach to RHIO data sharing and inter-change of electronic information emphasizing full control over data sharing through a centralized repository.

Components in a centralized architecture refer to the Central Data Repository (CDR) and the requestor.

RHIO Architecture – Part 3 Hybrid architecture as the name suggests, is a combination of the two architecture types where various data transactions occur based on a decentralized or centralized method. For instance, a RHIO may have pharmacy transactions occurring within a federated model while lab data is shared through a centralized database. The providers in a hybrid architecture may decide to share patient data through a CDR or peer to peer.

Hybrid architecture as the name suggests, is a combination of the two architecture types where various data transactions occur based on a decentralized or centralized method.

For instance, a RHIO may have pharmacy transactions occurring within a federated model while lab data is shared through a centralized database. The providers in a hybrid architecture may decide to share patient data through a CDR or peer to peer.

RHIOs: Emerging Issues No Federal guidelines at this point, but likely that they will emerge in the next several months; Key issues to be defined with respect to RHIOs: Geographic coverage Requirements regarding numbers of stakeholders/definition of “community” project Relationship to National Health Information Network (“NHIN”) Tax status of an entity Availability of Federal funding Certification/Accreditation Requirements in Federal Contracts State role in defining RHIOs Federal role likely to be permissive encouraging innovation in marketplace, while seeking to promote federal goal of interoperability through National Health Information Network

No Federal guidelines at this point, but likely that they will emerge in the next several months;

Key issues to be defined with respect to RHIOs:

Geographic coverage

Requirements regarding numbers of stakeholders/definition of “community” project

Relationship to National Health Information Network (“NHIN”)

Tax status of an entity

Availability of Federal funding

Certification/Accreditation

Requirements in Federal Contracts

State role in defining RHIOs

Federal role likely to be permissive encouraging innovation in marketplace, while seeking to promote federal goal of interoperability through National Health Information Network

Comments & References Contact Nainil Chheda www.nainil.com Reference: 1. HIMSS 2. RHIO WIKI 3. NHIN WIKI

Contact Nainil Chheda

www.nainil.com

Reference: 1. HIMSS 2. RHIO WIKI 3. NHIN WIKI