Introduction
The Community Health Information Networks (CHINs), according to the Ernest and Young health care practice are defined as “inter organizational systems that use information and telecommunication technologies to store, transmit and to transform clinical and financial information” (Payton, Brennan & Ginzberg, 1995, p. 1). CHIN is also defined as, “an organizational and technical entity that is designed and operated to facilitate the electronic data interchange and the integration of health care information for the benefit of those of organizations and health care professionals that participate in the network” (Friedman, Bruce & Mitchell, n.d., p. 8).
Technical aspect of CHIN concerns its connectivity and data repository whereas its organizational aspect may encompass its hardware, software and the architectural dimensions. The information stored can be shared by both cooperative and competitive participants. These participants can include the payers, the hospital institutions, the alternative health delivery systems, the clinics and the medical practitioners and also other health care providers. The CHIN can be categorized depending on their purpose, the participants, the services provided and the sources of funding. The four models of CHIN are the home health delivery, telephone based networks, voluntary and the enterprise.
The CHIN that is now in operation is the ComputerLink; this is mainly operational in the Cleveland among the medical caregivers and it specifically targeted those people who take care of those suffering from the Alzheimer disease. Other CHINS include the Wisconsin Health Information Network (WHIN) in the Milwaukee and the Integrated Medical systems in Colorado, CHMIS or Hartford foundation, SMS/HDX. For the sake of our discussion, am going to discuss WHIN and ComputerLink. The development of CHIN was prompted by the advancement in e-commerce which placed a heavy load on the health care demands and hence the revolutions of health care industry through the introduction of CHINs. CHINs facilitated timely, accurate and secure patient conditions (Tan, 2009).
Main analysis
The type of information that is shared by the CHINs is financial information which includes billing and other data, patient management which includes demographic information, admission-discharge information together with scheduling information and also clinical information which encompasses therapeutic data.
Providers for the CHINs
ComputerLink
This is a telephone accessible internet based computer network that is in practice in Cleveland. This CHIN was initially developed to cater for those who suffered from Alzheimer disease and of late it has been extended to include other medical care specialists. ComputerLink connects caregivers, health institutions and also the patients together with the public health agencies. This CHIN is aimed at reducing the degree of social isolation and the stigma that results from particular medical conditions.
The main participant in the ComputerLink is the Alzheimer Disease Association that operates under the auspice of National Institute of Aging. The other services provided by the ComputerLink are the decision support, email, encyclopedia and the bulletin board.
E-mail allows users to freely and anonymously communicate with the nurse moderator and also other providers of the Alzheimer medical services. The nurse-moderator will act as the connecting officers who will provide assistance to the users. The decision support services act as a guide for the users through several scenarios that allow self unwavering choices that are based on personal values. Consequently, the bulletin board facilitates the ability of the users to communicate via electronically supported public forum by all the participants in the CHINs.
Like other telephone oriented networks that are financed by organizations, ComputerLink have emerged as the comparatively cheap and an alternative to the ones provided by fully functioning centralized computer networks. This is due to the low cost provided by telephone links (Payton, Brennan & Ginzberg, 1995).
Wisconsin Health Information Network (WHIN)
The Wisconsin Health Information provider (WHIN) is dominant in the Milwaukee and is mainly intended to tract, access and to voluntarily make available patient and medical information. WHIN is owned and operated by a Baby Bell local telephone company called Ameritech that operate in the Midwest and also the Aurora Health Systems which is a conglomerate of providers of health care in Milwaukee.
To address its participants fully, WHIN is compatible with several other networks like hospitals, clinics, laboratories, pharmacies, insurers and the medical practitioners or physicians. The services offered by WHIN are the “verification of eligibility, the electronic claim submission, benefits review and the prescription-refill authorization” (Friedman, Bruce & Mitchell, n.d., p. 1); WHIN also delivers other services like application delivery, and human and financial resources that support its intiative. The services of WHIN majorly concern the health transactions which are instrumental for the operations of the health care providers. WHIN operates as a different entity from its member organization.
Consequently, the WHIN is considered one of the extensive CHIN since statistics indicate that it links approximately “thirteen hospitals, 1,700 doctors, five payers, 8 clinics and 12 ancillary service providers” (Friedman, Bruce & Mitchell, n.d., p. 1). Other responsibilities of WHIN are the processing of the patients claims and also their insurance eligibility information and to ensure access to clinical information like the laboratory results and the drug prescriptions (Friedman, Bruce & Mitchell, n.d.).
At present WHIN has limited functionality and the development of the clinic database is at its inception and it has not yet been proved.
Challenges facing CHINs
There are various challenges that bedevil CHINs; apart from the WHIN other CHINs could not see the light of the day and their viability was questioned. Among the problems that threatened the development of CHINs were the lack of substantive funding and the lack of connection by all partners to the internet through the Wide Area Network (WAN) and the standardization of data structure and transactions (Tan, 2009).
Conclusion
CHINs are preferable due to the fact that they are easier to finance, to implement and to operate; this is due to the limited number of participants that it targets. CHINs are dynamic and they have the tendency to change when there are some changes in the healthcare environment, more so the introduction of the federal and state legislations to govern healthcare is likely to alter the future revolution of CHIN. Adopting CHIN is a strategic target of any organization that provides health care. This is due to the tendency of CHINs to link all the existing information systems and it facilitates the creation of virtual teams that exist around the patient to facilitate the flow of patient information to all concerned parties. CHINs have evolved into a field of researchers and practitioners and have rebranded to be called Regional Health Information Network (RHIN) or otherwise referred as Regional Health Information Organisations (RHIO).
References
Friedman, J, Bruce, K & Mitchell, W. (n.d). Community Health Information Network (CHINS) and their Relationship to telemedicine. New York, NY: Jones & Bartlett Learning.
Payton, F., Brennan, P & Ginzberg, M. (1995). Needs determination for a Community approach to health care delivery. Special Issues Series on Management of Technology in Health Care. Int. J. Tech. Mgt. 1(1), pp 157–173.
Tan, J. (2009). Adaptive Health Management Information Systems: Concepts, Cases, and Practical Applications. New York, NY: Jones & Bartlett Learning.