NI:

1. U.S Federal Initiatives &
Public Private Partnerships

2.  In April 2004, the president of the United States issued an executive
order that called for action to put EHRs in place for most Americans in 10
years. Today there is growing consensus that EHRs, can meet clinical and
business needs in healthcare by capturing, storing, and displaying clinical
information when and where it is needed to improve treatment and to
provide aggregated cross-pattern data. Analysis the involvement of nurses
is critical to such efforts responsible for care coordination and promotion of
wellness, nurses are often the patient’s primary contact and the final point
in healthcare delivery where medical errors and other unintended actions
can be caught and corrected after a brief overview and discussion of the
definition of EHR-Ss, this chapter covers two main areas federal initiatives
and public-private partnership.

3. An early adopter of EHR-s the U.S government is currently
advancing initiatives to accelerate the use of hit in both the
public and private sectors. Both sectors have done considerable
EHR-S innovation and some notable benchmark implementation
over the past decade federal initiatives continue to actively
identify and target solutions that lessen the barriers and
accelerate use of EHR-S.

4.  The term EHR-S is often used interchangeably with
computerized patient record, clinically information system,
electronic medical record, and many others. As a term EHR-S is
recognized internationally by including the word system, the term
forces a distinction between an EHR, which is physical or logical
repository of data, and EHR-S, which can be made up of one or
more applications. At the time of writing, international organization
for the standardization (ISO) had drafted its standard for EHR
definition, escape, and context, ISO 20514; the final version was
expected in 2005 or 2006.

5. The IOM’s 1991 definition of computer-based patient record system is
currently the basis for domestic and international definitions of an EHR-S:
1. Longitudinal collection of electronic health information for and about
persons, where health information is defined as information pertaining to
the health of an individual or healthcare provided to an individual.
2. Immediate electronic access to person and population level information
by authorized, and only authorized, users.
3. Provision of knowledge and decision support that enhances the quality,
safety, and efficiency of patient care.
4. Support of efficient processes for healthcare delivery.

6.  Federal agencies that do not provide direct care are taking
multiple approaches to promote use of EHR-S. Federal
activities are focus on the development and adoption of
terminologies and standards, Grants for community
demonstrations of data exchange and other pilot projects.


7.  The executive of April 2004, mentioned earlier in the
chapter, created the ONCHIT to coordinate HIT efforts in the
federal sector and collaborate with the private sector in the
driving HIT adoption across the health care system. In July
2004, HHS secretary Tommy Thompson and Dr.Brailer release
a framework for strategic action. The office of the national
coordinator is positioned to bring together a public and private
entity for accelerating solutions to known problems.

8. 
 In 2000 and 2001, the national committee on vital
and health statistics (NCVHS), which advices the secretary of
HHS on health information policy, held a series of national
hearings to develop a consensus vision of the national health
information infrastructure (NHII).

9.  In 2003-2004, AHRQ unveiled a major HIT portfolio,
with grants, contracts and other activities to demonstrate the
role of HIT in improving patient safety band the quality of
care.

10.  As an independent advisor to the nation with the goal
of improving health, the IOM has championed the advantages of
IT to improve health since its 1991 foundational work the
computer base patient record, which was revised and
republished in 1997.