Databases Reference
In-Depth Information
The exchange of medical records brings with it potential liabilities that
must be addressed and controls must be put in place to limit who has
access to the records. This role is best undertaken by a governance body
that has the ability to bring a diverse group of healthcare stakeholders
to the table and to create trust relationships among them. Herein lies
the value of good governance. The governance organization must func-
tion as a neutral body to convene stakeholders, to work out the rules for
data-sharing activities, to establish business sustainability, and to hold all
participants accountable for their responsibilities for sharing health infor-
mation. Only through this deliberative method of building trust, agree-
ment, and accountability for sharing data will a healthcare community
lower its barriers to exchanging health records.
CASE STUDY: STATE-LEVEL GOVERNANCE
OF HEALTH INFORMATION EXCHANGE
The steady development of community-based HIE was disrupted in 2009
when the passage of the American Recovery and Reinvestment Act (ARRA)
p. 116) altered the health information technology landscape in the United
States. The law specifically targeted building a national HIE infrastructure
to support the creation of a Nationwide Health Information Network. The
Office of the National Coordinator for Health Information Technology
was authorized to develop a broad set of strategies to drive the adoption
of electronic health records systems, create interoperability among them,
and foster the exchange of medical records electronically. Funds were allo-
cated for paying incentives to doctors to adopt electronic health records
and to make them interoperable through the construction of state-level
health information exchange infrastructures.
A significant feature of the American Recovery and Reinvestment Act
created state-designated entities that would become the recipients of fed-
eral funding for health information exchange and would act as the de facto
governing boards of the new state-level infrastructure. With the passage
of this act, all 50 states and seven territories of the United States were
pulled into facing the realities of constructing an HIE infrastructure and
dealing with the issues of the governing of health information exchanges.
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