Joshi Sanjaya
Biomed Inform Insights. 2008 Dec 3;1:45-54. doi: 10.4137/bii.s2007. eCollection 2008.
A review of the current challenges, trends and initiatives around the various regulations as related to Health Informatics in the United States is presented. A summary of the functions in a workflow-based approach organized into the process and compliance for HIPAA, secure email and fax communications interfaces, e-prescriptions and patient safety and the health information technology savings claims versus costs follows: HIPAA compliance is complex; data interoperability and integration remains difficult.Email and faxing is possible with current over-the-shelf technologies within the purview of the HIPAA Security and Privacy rule.Integration of e-prescribing and NPI data is an area where health informatics can make a real difference.Medical errors remain high.There are no real savings yet from the usage of health information technologies; the costs for implementation remain high, and the business model has not evolved to meet the needs.Health Information Technology (Health IT) projects continue to have a significant failure rate; Open Source technologies are a viable alternative both for cost reduction and scalability. A discussion on the macro view of health informatics is also presented within the context of healthcare models and a comparison of the U.S. system against other countries.
本文介绍了美国当前围绕健康信息学相关各项法规的挑战、趋势和举措。以下是基于工作流方法组织的功能总结，包括HIPAA的流程与合规、安全电子邮件和传真通信接口、电子处方与患者安全以及健康信息技术节省的费用与成本对比：HIPAA合规复杂；数据互操作性和集成仍然困难。在HIPAA安全与隐私规则范围内，利用当前现成技术可以进行电子邮件和传真通信。电子处方与国家提供者识别码（NPI）数据的集成是健康信息学能够产生实际影响的领域。医疗差错率仍然很高。使用健康信息技术尚未带来实际节省；实施成本仍然很高，商业模式也未发展到满足需求的程度。健康信息技术（Health IT）项目的失败率仍然很高；开源技术在降低成本和可扩展性方面是可行的替代方案。本文还在医疗保健模式的背景下对健康信息学的宏观视角进行了讨论，并将美国系统与其他国家进行了比较。
