Pediatric Informatics: Computer Applications in Child Health (Health ...

31 Communities of Pediatric Care and Practice 403
geographic area and governs health information exchange among them for the
purpose of improving health and care in that community.” 16
The creation of RHIOs got a major boost with the issuance of the “Goals of
the Strategic Framework” by the Office of the National Coordinator for Health
Information Technology in July 2004. 17 In 2005, 65% of CIOs from academic medical
centers surveyed, indicated that they were participating in or forming a RHIO. 18
In 2006, over 160 RHIOs were counted by the e-Health Initiative. 19 Following
David Brailer’s resignation in 2006, literature references to RHIOs decreased significantly
(by late 2007), with “Health Information Exchange” becoming the more
global term for the various types of organizations pursuing this function.
31.5 HIE Functions
A full description of the functions of HIEs is beyond the scope of this chapter, but
an excellent summary of these can be found in the Conference Workbook of the
Development of State Level RHIOs Consensus Conference. 20 Key functions include:
Creating data standards and policies for data aggregation from remote sources
Providing a central data repository for aggregated data
Providing pointers to remote data
Although most HIEs 21 have a master patient index, not all have a central data
repository.
Types of access to remote data include:
Transactional:
unfiltered health data (e.g., the weight of a child at each visit and
date of care at one clinic)
Analytical:
filtered/processed data provided as value-added reports (e.g., comparison
of a child’s weight to normal values and plotting them on a growth chart)
Most HIEs provide transactional data in their early stages. The demand for efficient,
appropriate, and rapid presentation of health information from multiple
locations and systems may increase the prevalence of analytic data. Tools such as
clinical dashboards to aggregate, consolidate, and visualize data will be needed to
provide added value and to sustain HIEs.
31.6 HIEs Relationships to EMRs and PHRs
Electronic Medical Records (EMRs) and Personal Health Records (PHRs) are two
primary sources of patient data that HIEs can tap. Important concepts regarding the
linkage of HIEs, EMRs, and PHRs include:
Data relevance
Connection and access
Data reconciliation
Data sources