Local Health Information Infrastructure

The MI & T program participates in multiple IS initiatives that support and impact the quality, safety and timeliness of care for patients seen in the State public hospital system, the juvenile correctional system and multiple community clinics serving the under/uninsured in the New Orleans metropolitan area. We are currently collaborating on informatics initiatives with more than ten internal and external organizational and community partners with the goal of developing a local health information infrastructure (LHII).

Defining an LHII

The National Health Information Infrastructure (NHII) is envisioned as the technologies, standards, laws, policies, programs and practices that enable health information to be appropriately and safely shared among health decision-makers, including consumers and patients, to promote improvements in health and healthcare. The development of a vision for the NHII began more than a decade ago when an Institute of Medicine report, (The Computer-Based Patient Record), investigated computerized patient records and concluded a major coordinated national effort with federal funding and strong advisory support from private sector is needed to accelerate the pace of change in the United States. The path to a national network of healthcare information is through the development and networking of local initiatives linking health data sources with users. Such local systems are called Local Health Information Infrastructures.^[ref]  Also see: Strategies for Creating Successful LHII Initiatives by Nancy Lorenzi, PhD.

The Partnership for Access to Healthcare (PATH) is our primary partner in development of an LHII. PATH is a consortium of health care providers who came together in 1999 - a partnership based on common mission and goals - with a vision to develop a comprehensive, integrated system of care for the under/uninsured in the New Orleans metropolitan area. The partnership strongly believes that technology integration and information systems are key components to enabling collaboration between partners and change directed toward improving the coordination, continuity, quality and efficiency of care for the patients served by its member providers.

PATH LHII

The principal goal of the PATH LHII development effort is maximizing communication of clinical information to providers delivering services to patients within a distributed care model crossing various community-based health care organizations (HCOs). PATH has succeeded in establishing the governance structure and organizational relationships between community HCOs and promoting the building of the early technical foundation, MaRDI and CLIQ, for communication.

MaRDI and CLIQ currently support unidirectional information flow from the Medical Center of Louisiana (MCL) to clinicians working at MCL and PATH community health center (CHC) partners. We plan to extend communication, as part of the LHII, from uni- to bi-direactional information flow. Clinical and registration data from CHCs will be transferred to the CDR and made available to providers, independent of the partner location where the patient receives care. Two-way communication across community provider organizations is dependent upon an operational and technical infrastructure, which requires the electronic transfer of registration data from CHCs to a centralized repository, the adoption of standardized registration processes and a community-level master patient index.

The LHII has potential to provide clinical and administrative benefit by improving the efficiency, effectiveness and quality of care, improving clinician workflow and decision support by sharing patient information across multiple clinical sites, reducing duplicate and/or unnecessary testing, improving data analysis capabilities for disease management, preventive care and optimizing business practices.