Health Data in the Information Age Use, Disclosure, and Privacy (1994) / Chapter Skim
Currently Skimming:
Introduction
Introduction
Pages 27-39
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 27... ...
Gerry Middlemarch, a health services researcher at State University, 27
|
From page 28... ...
In particular, they need to decide: whether to renovate the only community hospital to expand traditional inpatient care services; whether to shift inpatient beds to rehabilitation and skilled nursing beds or to authorize construction of a new nursing home; and whether to establish additional neighborhood clinics for maternal and child care, to upgrade the emergency medical services system for both adults and children, or to add stafffor substance abuse facilities. How can they determine the community's greatest needs now andfive to ten years from now, and how can they calculate the most cost-effective use of the county's limited health budget?
|
From page 29... ...
Taken together, the committee's findings, conclusions, and recommendations underscore the extreme importance of the ways in which health care information is to be controlled and used in the future. ADVANCING THE PROSPECTS FOR COMPREHENSIVE HEALTH DATABASES AND NETWORKS The Problem The desire to understand and improve the performance of the health care system begets a need for data to answer the questions that opened this report.
|
From page 30... ...
Some problems relate to the content and structure of current health databases; others pertain more to the difficulties of creating and maintaining comprehensive databases. One major drawback is that most information gathered today reflects independent events and a single setting (almost always hospital admissions)
|
From page 31... ...
of that care, yet those wishing to make decisions about treatments or providers prefer, indeed require, outcome-related information. Even the clinical information, if gathered through insurance claims or encounter forms, may be quite limited and of questionable reliability and validity; if obtained from paper-based medical records, then considerable manual abstraction and computer data entry are required (all tasks that introduce their own inaccuracies and biases)
|
From page 32... ...
The interests that have prompted such action cover a broad range: controlling business costs attributable to health benefits; applying computer technologies to decrease costs of processing insurance claims; evaluating and improving health care; conducting technology assessments; planning the expansion and contraction of health care facilities and services across the nation; and transmitting medical history information for an increasingly mobile population. The success of health care reform as well as the ability to assess the effect of a reformed system on the health of the public depends on access to the kinds of data that too often are unavailable.
|
From page 33... ...
The Hartford Foundation has a long-standing interest in issues relating to the generation and application of information to improve health care delivery and to increase the value of health care spending. Its interests have intensified in the present context of vastly greater computer capabilities in the health care sector, increasing attention to health matters in the business community, rising interest among health professionals in understanding the effectiveness and appropriateness of the health care services they deliver, and growing sophistication among consumers about health care matters.
|
From page 34... ...
Apart from the major support for this project from the Hartford Foundation, additional funding was made available by the American Health Information Management Association, Electronic Data Systems Corporation (EDS) , and Science Applications International Corporation.
|
From page 35... ...
What current dangers arising from electronic data interchange and the widespread sharing of personal health data might continue, be exacerbated, be ameliorated, or be prevented by such entities?
|
From page 36... ...
Even when data for a given purpose appear to be adequate in these respects, many observers worry about using data for aims other than those originally intended; a case in point is the use of information originally intended for administrative functions to support patient care or quality assessment applications. Fourth, what about the "safety" of personal health data?
|
From page 37... ...
Among the issues are barriers to accessing certain categories of data, such as information on mental health or substance abuse treatment, and statutes establishing time limitations on keeping (or destroying) data.
|
From page 38... ...
; examined the impact of existing law on these organizations; advanced some short- and long-term options and strategies for privacy protection of patient-identified information; and gave particular consideration to the status and protection of clinical and other patient-identified data once they move beyond legal or other protections afforded to primary medical records. When IOM studies with national significance involve activities initiated at the grassroots, state, and local levels, the IOM often makes a concerted effort to reach out to a wide range of people in those locales.
|
From page 39... ...
COMMENT This report reviews the tremendous promise of regional health data networks for evaluating and improving health care and controlling its administrative costs. While the potential for great benefit to the public may be understood by those in the relevant fields, the potential for harm or lack of fairness in their use may create doubt and fear in many.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.