Abstract
The goal of health information infrastructure (HII) is to assure the availability of comprehensive electronic patient records when and where needed. An effective HII must overcome the challenges of privacy, stakeholder cooperation, incomplete information, and financial sustainability. The recent increased adoption of electronic health records by providers has created a real opportunity for HII implementation. Attempts to implement HII with systems that attempt real-time aggregation of institution-centric records stored in multiple locations for each person has been unsuccessful. The high implementation costs, incomplete data that inevitably results from lack of availability of all relevant information sources, and the difficulty of assuring ongoing stakeholder cooperation are key factors. A network of health record banks, community repositories of electronic health records with access controlled by patients, can address the key HII challenges. Privacy is protected by patient control, allowing each individual to establish and maintain their own privacy policy. Stakeholder cooperation can be accomplished by having individuals request their own data, invoking the legal requirement for providers to supply digital copies of their records on patient request. To achieve interoperability, ongoing financial incentives to providers can ensure that data supplied uses acceptable standardized formats. Financial sustainability can be achieved through new value created by the information itself when utilized for innovative applications for both patients and other health care stakeholders that are only possible when comprehensive records of individuals are available. Health record banking can therefore unlock the potential of HII to simultaneously lower costs and improve the quality of care.
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Notes
- 1.
The completion time of such a sequential search increases linearly with the number of records being examined. For example, in a modest-sized community with 500,000 patients, with retrieval and processing time of each patient’s records of just 2 s (a low estimate), such a search would take at least 12 days (1 million seconds). Even worse, every search requires that each connected EHR retrieve and transmit all its information.
- 2.
http://webwereld.nl/nieuws/54340/rotterdam-start-eigen-versie-elektronisch-pati--ntendossier.html. Posted January 14, 2009 (Accessed 26 December 2014).
- 3.
http://wiki.directproject.org/file/view/DirectProjectOverview.pdf (Accessed 26 December 2014).
References
Institute of Medicine. Committee on quality of health care in America. To err is human: building a safer health care system. Washington, DC: National Academy Press; 1999.
Masys DR. Effects of current and future information technologies on the health care workforce. Health Aff. 2002;21(5):33–41.
Bates DW. Using information technology to reduce rates of medication errors in hospitals. BMJ. 2000;320:788–91.
Kass, B. Reducing and preventing adverse drug events to decrease hospital costs. Research in action, Issue 1. 2001. AHRQ Publication Number 01-0020. Available at http://archive.ahrq.gov/research/findings/factsheets/errors-safety/aderia/ade.html. Accessed 26 Dec 2014.
Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998;280(15):1311–6.
McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. NEJM. 2003;348:2635–45.
Johnston D, Pan E, Walker J, Bates DW, Middleton B. The value of computerized provider order entry in ambulatory settings. Boston: Center for Information Technology Leadership, Partners Healthcare; 2003.
Walker J, Pan E, Johnston D, Adler-Milstein J, Bates DW, Middleton B. The value of healthcare information exchange and interoperability. Boston: Center for Information Technology Leadership, Partners Healthcare; 2004.
Hillestad R, Bigelow J, Bower A, Girosi F, Meili R, Scoville R, Taylor R. Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. Health Aff. 2005;24:1103–17.
Buntin MB, Burke MF, Hoaglin MC, Blumenthal D. The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Aff. 2011;3:464–71.
Balas EA, Boren SA. Managing clinical knowledge for health care improvement. In: Yearbook of medical informatics 2000: patient-centered systems. Stuttgart: Schattauer; 2000. p. 65–70.
Lipton E, Johnson K. The anthrax trail; tracking bioterror’s tangled course. New York Times, Section A, p. 1, 26 Dec 2001.
Wagner MM, Dato V, Dowling JN, Allswede M. Representative threats for research in public health surveillance. J Biomed Inform. 2003;36(3):177–88.
U.S. Department of Health and Human Services. Update on the adoption of health information technology and related efforts to facilitate the electronic use and exchange of health information. A report to congress. HHS Office of the National Coordinator for Health Information Technology. 2013.
Yasnoff WA, Sweeney L, Shortliffe EH. Putting health IT on the path to success. J Am Med Assoc. 2013;309(10):989–90.
Yasnoff WA. Health information infrastructure. In: Shortliffe EH, Cimino JJ, editors. Biomedical informatics: computer applications in healthcare and medicine. 4th ed. New York: Springer; 2014. p. 423–41.
Adler-Milstein J, Bates DW, Jha AK. Operational health information exchanges show substantial growth, but long-term funding remains a concern. Health Aff (Millwood). 2013;32(8):1486–92.
Yasnoff WA. Privacy, confidentiality, and security. In: Magnuson JA, FU PC Jr., editors. Public health informatics and information systems. 2nd ed. New York: Springer-Verlag; 2014. p. 155–72.
U.S. Department of Health and Human Services. The HIPAA privacy rule. Available at: http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/index.html. Accessed 12 Jan 2015.
California Health Care Foundation. National consumer health privacy survey. 2005. Available at: http://www.chcf.org/publications/2005/11/national-consumer-health-privacy-survey-2005. Accessed 26 Dec 2014.
Harris Interactive. Many U.S. adults are satisfied with use of their personal health records. 2007. Available at: http://www.harrisinteractive.com/vault/Harris-Interactive-Poll-Research-Health-Privacy-2007-03.pdf. Accessed 26 Dec 2014.
Blumenthal D, Squires D. Giving patients control of their EHR data. J Gen Intern Med. 2015;30 Suppl 1:S42–3.
DesRoches CM, et al. Electronic health records in ambulatory care – a national survey of physicians. N Engl J Med. 2008;359:50–60.
Hersh W. Healthcare information technology: progress and barriers. JAMA. 2004;292:2273–4.
Health Record Banking Alliance. A proposed national infrastructure for HIE using personally controlled records. 2013. Available at: http://www.healthbanking.org/docs/HRBA Architecture White Paper Jan 2013.pdf. Accessed 26 Dec 2014.
Lapsia V, Lamb K, Yasnoff WA. Where should electronic records for patients be stored? Int J Med Inform. 2012;81(12):821–7.
Yasnoff. Health record banking: a practical approach to the national health information infrastructure. 2006. Available at http://williamyasnoff.com/?p=26 Accessed 26 Dec 2014.
Health Record Banking Alliance. Principles and fact sheet. 2008. Available at http://www.healthbanking.org/docs/HRBA Principles & Fact Sheet 2008 FINAL.pdf. Accessed 26 Dec 2014.
Szolovits P, Doyle J, Long WJ, Kohane I, Pauker SG. Guardian angel: patient-centered health information systems. 1994 Technical report MIT/LCS/TR-604, Massachusetts Institute of Technology Laboratory for Computer Science.
Dodd B. An independent “health information bank” could solve health data security issues. Br J Healthc Comput Inf Manag. 1997;14(8):2.
Ramsaroop P, Ball M. The “bank of health”: a model for more useful patient health records. MD Comput. 2000;17:45–8.
Kostyack P. The emergence of the healthcare information trust. Matrix J Law Med. 2002;12(393).
Dyson, E. Personal health information: data comes alive! 2005. Release 1.0 24,1 (Sep).
Haislmaier EF. Health care information technology: getting the policy right. 2006. Available at http://www.heritage.org/Research/Reports/2006/06/Health-Care-Information-Technology-Getting-the-Policy-Right. Accessed 26 Dec 2014.
Ball M, Gold J. Banking on health: personal records and information exchange. J Healthc Inf Manag. 2006;20(2):71–83.
Shabo A. A global socio-economic-medico-legal model for the sustainability of longitudinal health records. Methods Inf Med. 2006;45:240–5 (Part 1), 498–505 (Part 2).
Health Record Banking Alliance. 2006. http://www.healthbanking.org. Accessed 26 Dec 2014.
State of Washington Health Care Authority. Washington state health information infrastructure: final report and roadmap for state action. 2006. Available at http://www.providersedge.com/ehdocs/ehr_articles/Washington_State_Health_Information_Infrastructure-Final_Report_and_Roadmap_for_State_Action.pdf. Accessed 26 Dec 2014.
Dossia Consortium. 2006. http://www.dossia.org. Accessed 26 Dec 2014.
Castro D. Improving health care: why a dose of IT may be just what the doctor ordered. Information Technology and Innovation Foundation. 2007. Available at http://www.itif.org/publications/improving-health-care-why-dose-it-may-be-just-what-doctor-ordered. Accessed 26 Dec 2014.
Gold JD, Ball MJ. The health record banking imperative: a conceptual model. IBM Syst J. 2007;46(1):43–55.
Kendall DB. Protecting patient privacy through health record trusts. Health Aff. 2009;28(2):444–6.
Health Record Banking Alliance. Health record banking: a foundation for myriad health information sharing models. 2012. Available at http://www.healthbanking.org/docs/HRBA Business Model White Paper Dec 2012.pdf. Accessed 26 Dec 2014.
Health Record Banking Alliance. Comments on: advancing interoperability and health information exchange (CMS- 0038-NC). 2013b. Available at http://healthbanking.org/pdf/HRBA Response to CMS-ONC RFI FINAL.pdf. Accessed 26 Dec 2014.
Yasnoff WA, Shortliffe EH. Lessons learned from a health record bank start-up. Methods Inf Med. 2014;53(2):66–72.
Steinbrook R. Personally controlled online health data – the next big thing in medical care? N Engl J Med. 2008;358(16):1653–6.
Mandl KD, Kohane IS. Tectonic shifts in the health information economy. N Engl J Med. 2008;358(16):1732–7.
Kidd MR. Personal electronic health records: MySpace or HealthSpace? Br Med J. 2008;336:1029–30.
Miller H, Yasnoff WA, Burde H. Personal health records: the essential missing element in twenty-first century healthcare. Chicago: Health Information and Management Systems Society; 2009.
Krist AH, Woolf SH. A vision for patient-centered health information systems. JAMA. 2011;305(3):300–1.
Yasnoff WA, Shortliffe EH, Shortell SM. A proposal for financially sustainable population health organizations. Popul Health Manag. 2014;17(5):255–6.
Turn R, Shapiro NZ, Juncosa ML. Privacy and security in centralized vs. decentralized database systems. Policy Sci. 1976;7:17–29.
Evaristo JR, Desouza KC, Hollister K. Centralization momentum: the pendulum swings back again. Commun ACM. 2005;48(2):66–71.
Agency for Healthcare Research and Quality. Costs and benefits of health information technology. Evidence report/technology assessment 132, publication 06-E006. 2006. Available at http://www.ahrq.gov/research/findings/evidence-based-reports/hitsys.pdf. Accessed 26 Dec 2014.
Microsoft. 2012. http://msdn.microsoft.com/en-us/healthvault/hh922966. Accessed 26 Dec 2014.
Hsiao CJ, Jha AK, King J, Patel V, Furukawa MF, Mostashari F. Office-based physicians are responding to incentives and assistance by adopting and using electronic health records. Health Aff (Millwood). 2013;32:1470–7.
Desroches CM, Charles D, Furukawa MF, et al. Adoption of electronic health records grows rapidly, but fewer than half of US hospitals had at least a basic system in 2012. Health Aff (Millwood). 2013;32:1478–85.
Laudon K. Markets and privacy. Commun ACM. 1996;39(9):92–104.
Herper M. Surprise! With $60 million genentech deal, 23andme has a business plan. Forbes, January 6, 2015. Available at: http://www.forbes.com/sites/matthewherper/2015/01/06/surprise-with-60-million-genentech-deal-23andme-has-a-business-plan/. Accessed 18 Jan 2015.
Yasnoff WA, O’Carroll PW, Freide A. Public health informatics and the health information infrastructure. In: Shortliffe EH, Cimino JJ, editors. Biomedical informatics: computer applications in healthcare and medicine. 3rd ed. New York: Springer-Verlag; 2006. p. 537–63.
Labkoff SE, Yasnoff WA. A framework for systematic evaluation of health information infrastructure progress in communities. J Biomed Inform. 2007;40(2):100–5.
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Yasnoff, W.A. (2016). The Health Record Banking Model for Health Information Infrastructure. In: Weaver, C., Ball, M., Kim, G., Kiel, J. (eds) Healthcare Information Management Systems. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-319-20765-0_20
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