Health Management and Policy, Saint Louis University, College for Public Health and Social Justice, Saint Louis, Missouri, USA.
J Am Med Inform Assoc. 2014 Jan-Feb;21(1):2-7. doi: 10.1136/amiajnl-2013-001719. Epub 2013 Jul 9.
The Office of the National Coordinator will be defining the architecture of the Nationwide Health Information Network (NWHIN) together with the proposed HealtheWay public/private partnership as a development and funding strategy. There are a number of open questions--for example, what is the best way to realize the benefits of health information exchange? How valuable are regional health information organizations in comparison with a more direct approach? What is the role of the carriers in delivering this service? The NWHIN is to exist for the public good, and thus shares many traits of the common law notion of 'common carriage' or 'public calling,' the modern term for which is network neutrality. Recent policy debates in Congress and resulting potential regulation have implications for key stakeholders within healthcare that use or provide services, and for those who exchange information. To date, there has been little policy debate or discussion about the implications of a neutral NWHIN. This paper frames the discussion for future policy debate in healthcare by providing a brief education and summary of the modern version of common carriage, of the key stakeholder positions in healthcare, and of the potential implications of the network neutrality debate within healthcare.
国家协调员办公室将与拟议中的 HealtheWay 公私合作伙伴关系一起定义全国卫生信息网络 (NWHIN) 的架构,作为一种开发和融资策略。存在许多悬而未决的问题,例如,实现健康信息交换的好处的最佳方式是什么?与更直接的方法相比,区域卫生信息组织的价值如何?运营商在提供这项服务中的作用是什么?NWHIN 是为公共利益而存在的,因此具有普通法概念“共同运输”或“公共呼叫”的许多特征,现代术语称为网络中立性。国会最近的政策辩论和由此产生的潜在监管对使用或提供服务的医疗保健的主要利益相关者以及交换信息的利益相关者都有影响。迄今为止,几乎没有关于中立的 NWHIN 的政策辩论或讨论。本文通过简要介绍普通运输的现代版本、医疗保健中的主要利益相关者立场以及医疗保健中网络中立性辩论的潜在影响,为未来的医疗保健政策辩论提供了框架。