Health Care Information Systems

Module 15 Health Information Networks and Internet Applications

The following objectives should be met by the end of this module:

• Describe an effective plan for implementing a Health Information Network (HIN)
• Discuss issues that affect planning of the HIN
• Discuss the history and the current state of the Internet
• Describe business strategies for HSOs using Internet and Intranet technology

These notes are intended only to supplement your readings. The best way to ensure each module is absorbed is to complete all the readings prior to reviewing these lecture notes. I will try to highlight what I believe to be the most important topics from your module readings. If you have any questions or concerns or there is something you do not understand, please ask me. You can either post on the webboard the question you have (that way others can benefit from the response), or you can e-mail me if you want a more private response. Either way it is extremely important that you have a complete and thorough understanding of the material for the module.

Integrated delivery systems are becoming dominant in our healthcare climate. To be effective they need strong governance and leadership, accessible primary care networks, greater physician alignment and involvement, sufficient capital, and responsive information systems. Health information networks (HIN) are information infrastructures within the integrated healthcare organization. HINs must be present to truly provide a continuum of care and they can have a presence in both the local community and in national/international arenas. A basic model of the enterprise model and the community based model are found in your text on pages 361 and 362.

An enterprise network is "established to support the information management and communication requirements of a single organization". They are generally based in private organizations rather than public and they are designed to serve the information needs of a single integrated healthcare system. These are the most common types of networks available today. The next level of HIN development is the community network model or the community health information network (CHIN). The goal of this type of HIN changes to "benefiting quality/cost factors for delivery systems within a regional, state, or national community of care, and to capitalize on the commonalties and noncompetitive threats among providers, payors, employers, government, and others to facilitate the open, seamless sharing of clinical, administrative, financial, and educational information in a standardized electronic format". The needs of the network are now focused on the broader based community rather than the individual system itself. National and global networks are the final level in the evolutionary model of HINs seen on page 364. These systems spread out to include even larger populations found on a national and international level.

Developing and implementing a HIN is expensive and time consuming. Estimates for cost can range from 30 million to over 250 million. Due to these commitments, planning should be of major importance to ensure the system is appropriate for the organization. The following list includes fundamental planning activities that should be addressed in any type of planning process for establishing a HIN infrastructure.

• Understand business objectives
• Assess current information system needs
• Identify information system requirements and user needs
• Determine type of organization or ownership
• Determine method of financing
• Address legal and security issues
• Establish infrastructure for managing networks
• Implement process for ongoing HIN evaluation and future development

Internet technology has been embraced by HSOs as an effective and inexpensive way to "deliver comprehensive, integrated care". Since the 1990s, health care organizations have begun to rapidly utilize the Internet. Strategies for using the Internet for healthcare include:

• Improving internal business processes and services
• Establishing external linkages with business partners
• Increasing marketshare and stability
• Providing public service information to the community

These strategies are linked with their Internet applications on page 386 in Figure 16.1 of your text.

Intranet is a term used to describe "internal Webs" or private computer networks based on Internet-derived technology. Intranets support a wide range of organizational goals and are involved in communication and distribution of information across the organization. Intranet applications include:

• Improving internal communication
• Distributing organizational information
• Delivering educational programs

Internet technology has many benefits for the healthcare organization. It is inexpensive, convenient to use, international in scope and is very user friendly. There are some disadvantages when beginning to use Internet technology in organizations. These include security issues, slow response time, and "being lost in cyberspace". This technology also encourages a change in the culture of the organization itself and must be managed well.

Recommendations for implementing Internet/Intranet technology:

1. Internet technologies must complement existing information systems
2. Establish a corporate-wide, interdisciplinary governance group to set policies, guidelines, technologies, and usage goals for Internet technology
3. Evaluate these technologies on current business strategies and processes
4. Develop a network of Internet experts who can support and advise
5. Ensure widespread access to Internet-derived technologies