Table 2.
Final Recommendations from NHII 03
| I. MANAGEMENT |
| A. Governance |
| 1. Public/private NHII Task Force |
| a. Steering group |
| b. Architecture task force |
| c. Privacy oversight |
| d. Patient safety task force |
| 2. Regional non-profit public/private health IT corporations to coordinate LHII investment |
| 3. NCVHS should have consumer representative |
| 4. “consumers' union” public/private partnership to rate quality |
| B. Education and Communication |
| 1. Inform public on NHII concept, implementation, privacy issues |
| 2. Educate senior executives & public about health IT & patient safety/quality link |
| 3. Health IT education for consumers |
| 4. Health IT education & hands-on experience required in health professional training |
| 5. Increased clinical informatics training |
| a. Health professionals |
| b. Clinical Informatics specialists |
| C. Shared Information Resources |
| 1. Shared repositories |
| a. Rules/knowledge for health IT systems |
| b. Nationally-vetted clinical guidelines |
| c. Biodefense preparedness |
| d. Data definitions, datasets, metadata for research |
| 2. National quality measurement database |
| 3. Facilitate alliances in research & population health communities |
| 4. Health promotion/prevention/treatment information available electronically to consumers |
| D. Metrics |
| 1. Establish metrics to track NHII progress, including |
| a. Biodefense preparedness |
| b. Availability in high-risk populations |
| c. Consumer management of patient information |
| d. Standardized safety & quality measures |
| 2. Tie funding to achievement of goals |
| 3. Measure and promote credibility of health information resources |
| II. ENABLERS |
| A. Financial Incentives* |
| 1. Acquiring health IT |
| a. Public/private financing: $10 billion |
| b. Loans for IT that leads to quality |
| c. Stimulate private investment |
| 2. Sustaining health IT (all payers) |
| a. Reimbursement for IT-driven care |
| b. Pay for quality & safety |
| 3. Financial incentives for standards use |
| 4. Research funding: private & government |
| a. Make standard data available |
| B. Standards* |
| 1. Reliable & consistent funding |
| 2. Adoption |
| a. Decrease barriers, increase benefits |
| b. Improve dissemination |
| c. Require use: |
| i. standards-based labeling for medications, tests, devices |
| ii. code clinical data with reference standards at its source |
| 3. Robust & nimble maintenance including |
| a. Designate core reference terminologies |
| b. Inter-vocabulary mapping |
| c. Alignment of message & terminology standards |
| d. Continue Consolidated Health Informatics Initiative for federal standards |
| 4. Include consumer data elements |
| 5. Consider privacy issues |
| C. Legal Issues |
| 1. Remove legal barriers to |
| a. Health IT investment |
| b. Health information sharing |
| c. Collaboration in a bioterrorism or other emergency |
| d. Safety & quality reporting |
| 2. Evaluate state & federal laws that affect NHII |
| a. Architecture |
| b. Development |
| c. Implementation |
| III. IMPLEMENTATION STRATEGY |
| A. Demonstration projects |
| 1. Community health information exchanges |
| a. 40-50 projects |
| b. Support safety & quality |
| c. Led by regional steering committees |
| d. Sharing of lessons learned |
| e. Coordinated national investment plan |
| f. Incremental interoperability approach |
| g. Include consumers, biodefense preparedness |
| h. Address privacy issues |
| B. Architecture* |
| 1. Architecture task force (ATF) applying key principles (see ▶) |
| 2. Align Public Health Information Network (PHIN) with NHII |
| 3. Affordable broadband to homes |
| C. Identifiers |
| 1. Resolve patient identification issue |
| a. Proceed without identifier |
| b. Review mechanisms for patient matching |
| c. New national unique patient identifier |
| d. Establish patient linkage algorithm for research ( < 100% accurate) |
| 2. New national unique provider identifier |
| IV. DOMAINS |
| A. Consumer Health* |
| 1. Establish personal health records (PHR) |
| a. No charge to consumers |
| b. Trusted authority |
| c. Using defined basic platform |
| 2. Promote e-health tools, e.g. |
| a. Link PHR to relevant information resources |
| b. Provide health alerts & decision support |
| 3. Evaluate role of individuals in control & management of medical information |
| B. Research* |
| 1. Research on impact of health IT on safety & quality: $1 billion/year |
| a. Evaluate existing systems |
| b. Improve adverse event detection algorithms |
| c. Improve methods for maximizing effectiveness of communicated information |
| d. Establish ethical, legal, and social issues (ELSI) program for NHII |
| e. Evaluate privacy policy options informed by public surveys |
*
One of the original breakout tracks.