The value of health information technology: filling the knowledge gap.

Despite rapid growth in the rate of adoption of health information technology (HIT), and in the volume of evaluation studies, the existing knowledge base for the value of HIT is not advancing at a similar rate. Most evaluation articles are limited in that they use incomplete measures of value and fail to report the important contextual and implementation characteristics that would allow for an adequate understanding of how the study results were achieved. To address these deficiencies, we present a conceptual framework for measuring HIT value and we propose a checklist of characteristics that should be considered in HIT evaluation studies. The framework consists of 3 key principles: 1) value includes both costs and benefits; 2) value accrues over time; and 3) value depends on which stakeholder's perspective is used. Through examples, we show how these principles can be used to guide and improve HIT evaluation studies. The checklist includes a list of contextual and implementation characteristics that are important for interpretation of results. These improvements will make future studies more useful for policy makers and more relevant to the current needs of the healthcare system.

Crossed wires: how yesterday's privacy rules might undercut tomorrow's nationwide health information network.

More than a decade after passage of the Health Insurance Portability and Accountability Act (HIPAA), concerns about the privacy and security of personal health information remain a major policy issue. Now, the emergence of the Nationwide Health Information Network (NHIN) presents deeper underlying privacy challenges, which will require renewed attention from policymakers as federal and state privacy rules need to be revisited. This is necessary because the current framework of privacy laws is not well suited for regulating a transformed health care system, where computer networks supersede conventional communications media.