Regional rollout focuses decision making improvements at point of care

Regional health information organizations are popping up across the country in response to the "Framework for strategic action," published by Dr. David Brailer, National Coordinator for Health Information Technology, Department of Health and Human Services.

The framework is intended as a guide for implementation of community-based, interconnected electronic medical records within 10 years. The community of Santa Barbara, CA, has a two-year head start with its Santa Barbara County Care Data Exchange (SBCCDE).

"SBCCDE was Dr. Brailer's vision of what we know today as a RHIO," said SBCCDE executive director Mike Skinner Monday at the HIMSS meeting.

Skinner shared the podium with Dr. David Channin, chief of imaging informatics at Northwestern University's Feinberg School of Medicine. He said SBCCDE, a 501c3 organization, is oriented around decision-making improvements at the point of care. The technical model is in the final phase of pilot testing.

"The president has called for an electronic medical record for all Americans within a decade," Channin said. "It's time to get started."

Channin then offered his first axiom: No single company or information system can meet all of the information management needs of a healthcare enterprise, much less all the requirements for a truly complete, distributed national and international EMR.

"Therefore, information systems must communicate with each other to successfully accomplish complex healthcare processes," Channin said.

Standards are necessary but not sufficient. This is where Integrating the Healthcare Enterprise comes in.

"There is too much wiggle room," he said. "IHE's Information Technology Infrastructure profiles can help achieve standardized content, container, identity correlation, repositories, and information locator."

Channin cited two ITI profiles in particular: patient identifier cross-referencing and patient demographics query.

He said conference attendees for the first time are being given the chance to experiment with interoperable EMR systems.

"In effect, a RHIO has been created on the conference exhibit floor, wherein anyone can create their own simulated health record to learn what patients may soon discover themselves as the country moves toward a national health information network," Channin said.

More than 40 vendors, providers, government agencies, regional health information databases, and standards development organizations have collaborated to create the temporary RHIO.