Nationwide Health Nationwide Health Information NetworkInformation Network

Presented byLori Blevins

Objectives:Objectives:

Describe the Nationwide Health Information Network (NIHN)

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: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 Nationwide Health Information NetworkInformation Network

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

Goals of NIHN: 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 NIHNFunction 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.

HardwareHardware 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 Hard diskDesktops Random access memoryLaptops Read-only memoryPDAs Cache memoryCPUs CD-ROMMotherboard

Personal Digital AssistantsPersonal 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

SoftwareSoftwareSun Microsystems Open Source softwareSun GlassFish Open Source Application PlatformJava Composite Application Platform SuiteSun Java Identity Management Suite

(Sun Microsystems 2009)

Sun Open Source TechnologySun 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 UsabilitySoftware Usability

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 groupsCompetitive analysis Participatory designContextual inquiry Exploratory lab studiesSurveys Heuristic evaluations

(Sun Usability Labs and Services 2009)

Nationwide Health Information NetworkNationwide Health Information Network

CONNECT Information SystemCONNECT Information SystemCONNECT has been developed by federal

agencies to link their existing systems

CONNECT is an open source gateway information system

CONNECT allows existing systems to “speak” to each other to facilitate the communication of healthcare information

(CONNECT Community Portal 2009)

CONNECT GatewayCONNECT 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 GatewayCONNECT 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 GatewayCONNECT GatewayCONNECT 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 NIHNAdvantages 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 NIHNDisadvantages 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 IssuesEthical/Legal Issues

Privacy issues

Security of computers linked to the NIHN

Confidentiality and disclosure of data

(Terry, 2009)

Informatics CompetenciesInformatics CompetenciesAbility 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 SpecialistInformatics Nurse SpecialistCompetencies:

Graduate degree in Nursing Informatics

Certificate in Nursing Informatics

Certification in Nursing InformaticsANCCHIMSS

(McGonigle and Mastrian 2009)

Function of Nursing Informatics Function of Nursing Informatics SpecialistSpecialistIncrease efficiency

Ensure smooth transition

Minimize impact of change

Educate staff members

(McGonigle and Mastrian 2009)

SummarySummaryNIHN will connect healthcare providers

Efficient sharing of pertinent data

Minimize risk of errors

Reduce inefficiencies and duplication of services

Lower healthcare costs

ReferencesReferences CONNECT Community Portal. Retrieved July 10, 2009.

www.connectopensource.org.

McGonigle, 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.