Regional Health Information Exchange
In the 21st century, access to information has become a critical development issue in the society. The healthcare sector has not been left behind as physicians, healthcare facilities and other stakeholders have come to a realization that easier data access and data sharing has many benefits in service delivery. According to Addelhak, Grostick & Hanken (2014), healthcare institutions have come to a realization that access to the right kind of information leads to improved service delivery as well as quality enhancement in all the industry. Data access in healthcare also addresses all sorts of inefficiencies that may confront a physician, a health provider or a health facility. The over the last two decades healthcare providers have realized that local and even national wide access to client medical information can lead to better and efficient service delivery. This realization has resulted in the emergence of numerous regional health information networks. This research paper addresses the Wisconsin Health Information Network and its benefit to improved healthcare delivery.
The Wisconsin health information network was established with the aim of facilitating improvements in the Wisconsin’s quality of care, transparency, patient safety as well as enhancing the efficiency and the effectiveness of service delivery in the region through the establishment of electronic data systems (Pemble, 1994). This idea was guided by numerous challenges experienced by physicians, hospitals and other health providers when caring for a patient. For instance, it was noted that as much as 30 percent of previous client information was unavailable on any given physician office visit, especially on prior diagnosis, laboratory results as well as other relevant medical history (Pemble, 1994). The ever increasing demand for convenient and accessible and efficient service delivery in healthcare was also another challenge that prompted the need for regional health information networks (RHIN). The need for regional health information networks was guided by the fact that a client seeks medical services in a broad “continuum” with primary care physicians, clinics, specialists, reference laboratories, hospitals and even diagnostic centers (Magnuson & Fu, 2014). Therefore, without a network or a platform in which all these entities could come together and access a client’s medical history, there was no guarantee of adequate care from any service provider.
To address this issue, different health providing entities in Wisconsin realized the need of coming up with a process of sharing client information in the region for efficient and effective health care delivery system. According to Fontaine et al. (2010), there is a need for current, complete as well as accurate patient information during a visit to a healthcare provider. To achieve that, health care providers in this region realized that implementation of integrated computer-based systems with patients’ records such as the Wisconsin’s Health Information Network (WHIN) was the only way of addressing the challenges mentioned above. Healthcare providers as well as other authorized medical information users such as; employers, payers, health care consortiums and laboratories within a region need to access a patient’s demographic and clinical data. In this case, patient data was collected through the US Postal Service and couriers, countless phone calls as well as proprietary networks to particular components of the community structure (Pemble, 1994). Once client data was obtained, it was accessed from the regional health information network that gave access all the integrated medical information providers through dial connections.
According to the provided article, there were eleven (11) medical centers signed into the Wisconsin’s Health Information Network (WHIN) as of August 1, 1994. There were also three payers, two ambulance companies and one nursing home that had signed into the network. Even with these statistics that seemed to suggest that the project was a success, there were a few challenges that were encountered. For instance, while the primary object of implementing the Wisconsin’s health information network was to offer patient information, most of the entities that had signed into this network were competitors (Pemble, 1994). This in itself was a significant challenge because the participants worried that sharing “their” information and relinquishing its control would make them lose their competitive advantage. Furthermore, some of the entities were concerned that their direct competitors would use this information to harm their rival’s business interests. Therefore, convincing these parties to abandon their worries aside and participate in the program was one of the main challenges that faced the implementation program. Abdelhak, Grostick & Hankem (2014) also argued that the value of such a network in itself is not sufficient, in and of itself to attract political and financial support. These authors argue that this is because it must be considered in term of-of benefits to each and every participant in the health care system of the region involved. This included patients, payers, providers as well as the communities involved. The fact that the cost of health information exchange sometimes may need to be borne by the larger market area and simply the biggest payer’s groups and providers was also a challenge. The Wisconsin regional health providers realized that health information exchange requires collaboration from both the healthcare industry and also among competitors was a big problem. According to Magnuson & Fu (2014), while other industries thrive from information exchange, the health care sector finds it difficult to survive in the same.
Initially, the Wisconsin health information exchange network faced challenges that have been experienced in other regions. However, it may have survived these challenges as witnessed in its success today. According to Abdelhk (2014), the Wisconsin health information network encountered the same issues being experienced in every other health information exchange network today. For instance, it was realized that lack of a sustainable operation model was a major obstacle in the healthcare industry despite technological advancements. This is because a health care exchange system needs to be able to guarantee security, store data, integrate disparate data sources, administer databases, build and maintain a master patient index, provide technical support and also find technologically capable partners. In the provided article, it is evident that Wisconsin’s regional health information network was able to achieve that. For instance, the information provider interface implemented ensured that all the data collected was properly integrated creating a sustainable systems environment for all medical health providers, while at the same maintaining their investments in all software and hardware involved (Pemble, 1994). The system was also able to bring together different health care providing facilities who believed in the security of this network. According to the article, the system installed was able to maintain all network user authorization and authentication information, as well as maintaining all routing functions of the network.
The success of this program was also primarily dictated by the two data flow model installed in the system. The request/response which was the primary model allowed all signed in user to connect to the network and request for information regarding a patient’s medical history, and get a response within 3-7 seconds (Fontaine et al, 2010). This efficiency is what encouraged even major competing entities trust in the network and agree to share their information. The second model, “event-driven”, ensured that medical information providers are the primary initiators of a client’s data flow. According to Magnuson & Fu (2014), the mission of every sane health care provider is participating in improving the health, safety as well as the well-being of a client. That being the case, a medical information provider is also guided by the same drive, hence; initiating a customer’s data flow would not be an issue. These two data flow models encouraged the different health information providing entities to take control of their work, coming to a realization that offering information on the network was for the better good of Wisconsin. Furthermore, according to the provided article, there was a 254% increase in WHIN usage over this network between the first quarters of the year 1992 to the first quarter of the following year (Pemble, 1994). These fluctuations are evident and prove that the WHIN network was able to overcome the management challenges, security problems, and data withholding challenges witnessed in other healthcare systems observed in the county.
In the recent times, many health information networks are developing in different parts of the country. As a matter of fact, these systems are now receiving both state and federal governments support (Abdelhak, Grostick & Hanken, 2014). The establishment of Health Information Technology for Economic & Clinical Health (HITECH) Act of 2009 was evident that the federal government encourages the implementation of health information networks for better healthcare delivery. However, from my experience, I believe that larger entities are still refusing to share client information with their competitors. They do not want to lose the competitive advantage; hence, prefer sharing only what they deem necessary. Other entities have limited this information and it is only available in ‘read only’ trying to protect what they consider as proprietary information. If I were to do things differently, the only thing I would change from the Wisconsin’s Health Information Network is introducing a flat subscription fee for all entities seeking signup in the regional network. Having monthly subscription fee for every entity that aims to join would address financial challenges that might face a healthcare information system. It might also bring a feeling of equity, prompting all the entities to offer all necessary client information. I would also seek to educate the health service providers, the physicians as well as all the stakeholders on regional health benefits brought about by data sharing in the healthcare sector.
References
Abdelhak, M., Grostick, S., & Hanken, M. A. (2014). Health information: management of a strategic resource. Elsevier Health Sciences.
Fontaine, P., Ross, S. E., Zink, T., & Schilling, L. M. (2010). Systematic review of health information exchange in primary care practices. The Journal of the American Board of Family Medicine, 23(5), 655-670.
Magnuson, J. A., & Fu, P. C. (2014). Public health informatics and information systems. London, UK: Springer.
Pemble, K. R. (1994). Regional health information networks: the Wisconsin Health Information Network, a case study. In Proceedings of the Annual Symposium on Computer Application in Medical Care (p. 401). American Medical Informatics Association.
