Assessing HIE stakeholder readiness for consumer access: lessons learned from the NHIN trial implementations.

Personal health records (PHRs) have the potential to empower patient decision-making. Integrating PHRs into the nation's health information infrastructure via the Nationwide Health Information Network (NHIN) may accelerate their adoption and use. PHR and NHIN technical development activities are advancing, but little is known about provider acceptance of PHR usage in this manner. Researchers conducted semi-structured interviews with organizations participating in an operational health information exchange to elicit opinions regarding such integration. The conversations identified important concerns that need to be addressed in order to achieve the vision established in the Consumer Access to Clinical Information Use Case outlined by the American Health Information Community. These challenges include provider workflow, authentication of consumer access, impact on provider-patient communication and consumer health literacy. Developers, policymakers, providers and patients should work together to confront and find solutions to these challenges to achieve the full potential of PHRs in the healthcare system.

Building a production-ready infrastructure to enhance medication management: early lessons from the nationwide health information network.

Poor medication management practices can lead to serious erosion of health care quality and safety. The DHHS Medication Management Use Case outlines methods for the exchange of electronic health information to improve medication management practices. In this case report, the authors describe initial development of Nationwide Health Information Network (NHIN) services to support the Medication Management Use Case. The technical approach and core elements of medication management transactions involved in the NHIN are presented. Early lessons suggest the pathway to improvements in quality and safety are achievable, yet there are challenges for the medical informatics community to address through future research and development activities.