Nationwide Health Information Network Presented by Lori Blevins

Objectives: � Describe (NIHN) the Nationwide Health Information Network � Determine the advantages and/or disadvantages of the NIHN from the viewpoint of the healthcare provider � Identify any ethical issues that may arise from implementation of the NIHN � Identify the role of the nursing informatics as it applies to the NIHN � Describe the hardware and software utilized by NIHN

Objectives: � Evaluate the usability of CONNECT Gateway as it relates to NIHN � Describe the advantages and disadvantages of NIHN � Discuss ethical and legal issues that pertain to NIHN � Describe competencies required for the nurse who may work with the NIHN system � Discuss functions and responsibilities of the informatics nurse specialist who implements the NIHN

Nationwide Health Information Network NHIN will provide a secure health information infrastructure that will connect providers, consumers and supporting healthcare workers

Goals of NIHN: � � � � Develop capability for secure data exchange Improve the coordination of care information among healthcare facilities Ensure that appropriate information is available at the time and place that care is provided Ensure that consumer’s healthcare information is secure and confidential Reduce risks from medical errors and support the delivery of appropriate care Provide consumers with access to their health information Lower healthcare costs by reducing inefficiencies, medical errors, and incomplete patient information (Nationwide Health Information Network 2009)

Function of NIHN The NIHN will serve as a “network of networks” to connect diverse entities that need to exchange health information. The NIHN will provide for a more effective healthcare marketplace and will promote greater competition, as consumers may realize increased choice in selecting healthcare providers. Accessibility of accurate healthcare information will enhance delivery of care and improve outcomes.

Hardware � The hardware utilized by the NIHN will consist of the myriad operating systems that are part of the network. Therefore, the hardware will consist of the hardware components of the participating entities and will include: PCs Desktops Laptops PDAs CPUs Motherboard Hard disk Random access memory Read-only memory Cache memory CD-ROM

Personal Digital Assistants � These small, hand held devices are becoming more commonplace among healthcare workers � PDAs will enable healthcare workers to enter data in a more timely fashion, so that patient information is updated in real time � The premise of the NIHN is to make health information readily available and accessible to all facets of healthcare delivery. Therefore, PDA’s are a logical choice in implementation of the NIHN

Software � Sun Microsystems Open Source software � Sun Glass. Fish Open Source Application Platform � Java Composite Application Platform Suite � Sun Java Identity Management Suite (Sun Microsystems 2009)

Sun Open Source Technology Sun Microsystems open source software is the backbone of the NIHN-CONNECT gateway This software will connect the 26 NIHN member agencies – hence the name NIHN-CONNECT The CONNECT software will be available throughout the health information exchange community (Sun Microsystems 2009)

Software Usability refers to the ease with which an interface can be used Sun Microsystems project teams employ a Usability Lab to enhance user-centered design and evaluation Evaluations include: Customer field studies Usability focus groups Competitive analysis Participatory design Contextual inquiry Exploratory lab studies Surveys Heuristic evaluations (Sun Usability Labs and Services 2009)

Nationwide Health Information Network

CONNECT Information System � CONNECT has been developed by federal agencies to link their existing systems � CONNECT system is an open source gateway information � CONNECT allows existing systems to “speak” to each other to facilitate the communication of healthcare information (CONNECT Community Portal 2009)

CONNECT Gateway �CONNECT is a special purpose open source information system �CONNECT will be used by physicians, nurses, clinicians, and administrators – anyone within the organization with access to the EHR

CONNECT Gateway �The primary function of CONNECT Gateway is to inter-relate separate agencies so that their information systems become connected “If the NIHN is the information exchange, CONNECT is the universal on-ramp for federal agencies” (CONNECT Community Portal 2009)

CONNECT Gateway �CONNECT will utilize ANSI and Healthcare Informatics Standard Planning Panel �SNOMED will be employed as the disease/procedure classification �CONNECT will encompass many types of configurations

Advantages to NIHN � Improve coordination of care � Appropriate information is available when and where it is needed � Reduce risk of medical errors � Reduce inefficiencies and duplication of services � Lower health care costs

Disadvantages to NIHN � May create a paternalistic environment in healthcare � May focus emphasis on the electronic health record and not the patient � Accuracy of information may be questionable � Possibility of security breach

Ethical/Legal Issues �Privacy issues �Security of computers linked to the NIHN �Confidentiality and disclosure of data (Terry, 2009)

Informatics Competencies �Ability to chart using EHR basic computer literacy and familiarity with software used �Ability to retrieve and evaluate data using EHR must be competent in computer skills needed within facility

Informatics Nurse Specialist Competencies: �Graduate degree in Nursing Informatics �Certification ANCC HIMSS in Nursing Informatics (Mc. Gonigle and Mastrian 2009)

Function of Nursing Informatics Specialist �Increase �Ensure efficiency smooth transition �Minimize �Educate impact of change staff members (Mc. Gonigle and Mastrian 2009)

Summary �NIHN will connect healthcare providers �Efficient sharing of pertinent data �Minimize risk of errors �Reduce inefficiencies and duplication of services �Lower healthcare costs

References � CONNECT Community Portal. www. connectopensource. org. Retrieved July 10, 2009. � Mc. Gonigle, D. , Mastrian, K. and Terry, N. (2009). Nursing Informatics. Sudbury, MA. Jones and Bartlett Publishers. � Nationwide Health Information Network (NHIN): Background & Scope. Retrieved 5/27/2009. www. healthit. hhs. gov. � Sun Microsystems Helps U. S. Federal Government. Retrieved 06/10/2009. www. sun. com. � Sun Usability Labs and Services. Retrieved 06/10/2009. www. sun. com/usability. � Terry, Nicholas P. NCVHS Subcommittee on Privacy. Retrieved 07/28/2009. www. ncvhs. hhs. gov.