A Feasible, Patient-Centric Architecture for Effective Community Health Information Infrastructure

January 30, 2018
Free for AMIA members; $50 for non-members
William Yasnoff, MD, PhD, FACMI

Statement of Purpose

Over the past several years, it has been widely recognized that the U.S. health care system needs a Health Information Infrastructure (HII), to reduce errors, improve quality and increase efficiency.  The ultimate objective of the HII is to assure immediate availability of complete patient information and decision support whenever and wherever care is delivered.  A local or regional approach involving sharing of electronic records among all health care organizations and providers has been advocated by stakeholders, and health information infrastructure development efforts have been ongoing in communities across the nation. However, no clear path leading to success for these projects has been defined.  At least three heretofore insoluble problems must be simultaneously overcome: 1) providing financial incentives to office-based physicians for provision of patient information from electronic health record (EHR) systems; 2) assuring overall financial sustainability; and 3) giving patients control over their health care information. 

To address these issues, a central repository for medical record information controlled by patients has been proposed.  Known as a Health Record Bank or HRB, it is low cost, simple to operate, and greatly reduces many of the vexing and time-consuming organizational, legal, governance, and technical issues that have been problematic in prior implementation efforts. The Health Record Banking model may be helpful in accelerating community progress toward the goal of delivering complete patient information at any point of care.

Target Audience

The target audience for this activity is professionals and students interested in biomedical and health informatics.

Learning Objectives

After participating in this activity, the learner should be better able to:

  •  Achieve 21st Century Cures Act goals for developing capacity for patient access to their electronic health information
  •  Understand the key challenges that must be overcome to create a successful health information infrastructure (HII)
  •  Explain how PCEHR data can be organized in a central repository to protect privacy, allowing authorized sharing, while preventing large-scale data loss
  •  Describe how a PCEHR system can be organized to be financially self-sustaining

Presenter Information

William A. Yasnoff, MD, PhD, FACMI
Managing Partner, National Health Information Infrastructure Advisors
Adjunct Professor, Health Sciences Informatics, Johns Hopkins

Dr. Yasnoff is an internationally-recognized health informatics consultant.  He initiated and led the activities at the U.S. Department of Health and Human Services resulting in the President's creation of the Office of the National Coordinator for Health IT.  Earlier, he built the nation’s first statewide immunization registry and then spent five years doing pioneering work in public health informatics at the Centers for Disease Control and Prevention.  He is a Member of the IOM/NAM Board on Population Health and Public Health Practice, Adjunct Professor of Health Informatics at Johns Hopkins, and Associate Editor of the Journal of Biomedical Informatics.  Dr. Yasnoff is the author of over 400 publications and presentations, including the "Health Information Infrastructure" chapter of the widely used textbook Biomedical Informatics: Computer Applications in Healthcare and Medicine.  He earned his PhD in computer science and MD from Northwestern, received an honorary DrPH from the University of Louisville in 2006, and was elected a Fellow of the American College of Medical Informatics in 1989.

Dr. Yasnoff has been quoted, and/or published in: JAMIA, Journal of Biomedical Informatics, International Journal of Medical Informatics, Methods of Information in Medicine, JAMA, NEJM, and the New York Times.

Accreditation Statement

The American Medical Informatics Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement

The American Medical Informatics Association designates this live activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Criteria for Successful Completion

Completion of this activity is demonstrated by:

  • Viewing the live webinar
  • Completion of the evaluation survey emailed at the webinar’s conclusion, and
  • Verification of attendance through the participant’s electronic report through the individual login to AMIA Central at www.amia.org.

The physician participant will be able to generate a CME certificate through the AMIA automated system.

For a certificate of completion, contact Pesha@amia.org.

Commercial Support

No commercial support was received for this activity.

Disclosure Policy

As a provider accredited by the ACCME, AMIA requires that everyone who is in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest for 12 months prior to the educational activity.

The ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.
Faculty and planners who refuse to disclose relevant financial relationships will be disqualified from participating in the CME activity. For an individual with no relevant financial relationship(s), the participants must be informed that no conflicts of interest or financial relationship(s) exist.

AMIA uses a number of methods to resolve potential conflicts of interest, including: limiting content of the presentation to that which has been reviewed by one or more peer reviewers; ensuring that all scientific research referred to conforms to generally accepted standards of experimental design, data collection, and analysis; undertaking review of the educational activity by a content reviewer to evaluate for potential bias, balance in presentation, evidence-based content or other indicators of integrity, and absence of bias; monitoring the educational activity to evaluate for commercial bias in the presentation; and/or reviewing participant feedback to evaluate for commercial bias in the activity.

Disclosures for This Activity

These faculty, planners, and staff who are in a position to control the content of this activity disclose that they and their life partners have no relevant financial relationships with commercial interests:

Webinar faculty: William A. Yasnoff
Working Group lead: Christina Stephan; Roland Gamache

AMIA staff: Susanne Arnold, Pesha Rubinstein

Instructions for Claiming CME/CE Credit

• Login to your account at amia.org; in upper right hand corner, click on AMIA Central
• Go to “My Events" under Membership/Activities
• Click “Apply for Credits" for this webinar
• Follow the instructions on the Credit Registration page. Be sure both drop-down menus say “physician”
• To print out your certificate, go to "My CME/CE Credits" under Membership/Activities.
• Physicians will be able to print out or save their CME certificates.
o Other attendees: if you require a certificate of participation, please contact pesha@amia.org

Contact Info

For questions about webinar access, email Susanne@amia.org.
For questions about content or CE, email Pesha@amia.org.