Databases Reference
In-Depth Information
Implementing an electronic health record software system comes with
associated expenses that include financial capitalization, technical train-
ing, and practice down time while the system is installed and learned.
Adoption has been slow among American physicians because of these
costs, but it is taking place inexorably due to government incentives and
market pressures. Once the physician's office is fully electronic, then the
potential to connect to a health information exchange becomes possible.
Health information exchanges have been emerging over the past decade
as the principal means to provide for the bidirectional transfer of health
records between physicians. The step up to a health information exchange,
though, brings the physician out of his or her office into a community of
physicians who can now access the same records for the coordination of
patient care.
VALUES OF HEALTH INFORMATION
EXCHANGE (HIE) GOVERNANCE
Moving from a single point of care to coordinated points of care requires
managing multiple partners and often divergent perspectives, all of whom
are connected through the electronic exchange of health information. Thus,
the development of the health information exchange (HIE) brings with it
the need to create an effective form of governance to manage the com-
munity of healthcare participants who are connected within the exchange
network. These participants may have diverse or competing interests, dis-
similar needs for data, unique requirements for the practice of medicine,
and different technical capabilities. To make this all work at a community
level, a governance group needs to be created, preferably a trusted body
of members from the healthcare community who can address compet-
ing interests and craft a consensus for the rules of exchange among par-
ticipants in the HIE. The consensus-building and leadership values that
a trusted, neutral group of people can bring to the governance of health
information exchange are essential for its success.
The following discussion looks at the important issues in developing a
governing organization for health information exchange and addresses the
value a governing board brings to the exchange of health data. All health
information exchanges entail data access, data sharing, and the authoriza-
tions required to share protected health information among physicians.
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