HIE growing pains
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| Beth Walsh, Editor, CMIO |
The board said that “the best step was to allow the state to operate from a clean slate.”
Perhaps the challenges HIPTN faced are part of the reason that the eHealth Initiative responded to the Office of the National Coordinator for Health IT’s (ONC) request for information on a governance mechanism for the Nationwide Health Information Network (NwHIN) by saying that the agency should take its time.
An unsigned letter from the Washington, D.C.-based health IT advocacy organization stressed that the ONC should diligently seek public comment before it begins developing regulatory and governance structures for the NwHIN.
The maturity of individual HIE business models should be considered when constructing a timeline for the NwHIN’s development, as most have yet to reach critical mass. The timeline outlined in the request for information (RFI) incorrectly presumes a higher level of maturity than actually exists, eHI suggested.
A future NwHIN governance structure should also take into account existing laws, regulations and initiatives at the state and federal levels to support systemwide redesign that is taking form in, for instance, accountable care organizations and patient-centered medical homes.
Several other organizations have submitted their response to the RFI. Hopefully, careful planning and consideration early on will result in little need to refine the process after the fact.
Meanwhile, studies are looking at ways HIEs can improve. For example, despite the increasing prevalence of EHRs in healthcare settings, automated care quality measurement has yet to become a widespread reality because care guidelines are not always specified, data are not standardized and much of the information required for automation is contained in unstructured formats, according to research published in the American Journal of Managed Care.
To assess whether these challenges could be overcome, researchers from the Portland, Ore.-based Kaiser Permanente Northwest Center for Health Research developed an automated quality assessment method that returned mixed results when tested in two separate healthcare systems.
By conducting a manual review of patient charts and comparing it to the quality measurement system’s performance, researchers determined that measurements did well in Kaiser Permanente’s highly integrated system, achieving an average measure accuracy of 88 percent, a mean sensitivity of 77 percent and a mean specificity of 84 percent.
Please share your experience with HIE.
Beth Walsh
CMIO Editor
bwalsh@trimedmedia.com
Beth Walsh,
Editor
Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.