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The nationwide health information network (NHIN) has been proposed to securely link community and state health information exchange (HIE) entities to create a national, interoperable network for sharing healthcare data in the USA. This paper describes a framework for evaluating the costs, effort, and value of nationwide data exchange as the NHIN moves toward a production state. The paper further presents the results of an initial assessment of the framework [...]

Recent federal policies and actions support the adoption of health information exchange (HIE) in order to improve healthcare by addressing fragmented personal health information. However, concerted efforts at facilitating HIE have existed for over two decades in this country. The lessons of these experiences include a recurrence of barriers and challenges beyond those associated with technology. Without new strategies, the current support and methods of facilitating HIE may not address [...]

The logical observation identifiers names and codes (LOINC) database contains 55 000 terms consisting of more atomic components called parts. LOINC carries more than 18 000 distinct parts. It is necessary to have definitions/descriptions for each of these parts to assist users in mapping local laboratory codes to LOINC. It is believed that much of this information can be obtained from the internet; the first effort was with Wikipedia. This [...]

Described are the changes to ICD-10-CM and PCS and potential challenges regarding their use in the US for financial and administrative transaction coding under HIPAA in 2013. Using author constructed derivative databases for ICD-10-CM and PCS it was found that ICD-10-CM's overall term content is seven times larger than ICD-9-CM: only 3.2 times larger in those chapters describing disease or symptoms, but 14.1 times larger in injury and cause sections [...]

The authors report on the development of the Cancer Tissue Information Extraction System (caTIES)--an application that supports collaborative tissue banking and text mining by leveraging existing natural language processing methods and algorithms, grid communication and security frameworks, and query visualization methods. The system fills an important need for text-derived clinical data in translational research such as tissue-banking and clinical trials. The design of caTIES addresses three critical issues for informatics [...]

Personal health records (PHRs) are information repositories; however, PHRs may be less available to persons in the safety net setting. We deployed a free, secure, internet-based PHR for persons receiving care at the AIDS/HIV clinic at San Francisco General Hospital. In our initial rollout, 221 persons registered for the PHR. Compared to the entire clinic, these initial users were more likely to be Caucasian, male, non-Hispanic, on antiretroviral medications, and [...]

To study the effects of using a population-based informatics system for osteoporosis screening and treatment in women aged 65 years or older.

The Massachusetts eHealth Collaborative (MAeHC) was formed to improve patient safety and quality of care by promoting the use of health information technology through community-based implementation of electronic health records (EHRs) and health information exchange. The Collaborative has recently implemented EHRs in a diverse set of competitively selected communities, encompassing nearly 500 physicians serving over 500,000 patients. Targeting both EHR implementation and health information exchange at the community level has [...]

The authors study two approaches to assertion classification. One of these approaches, Extended NegEx (ENegEx), extends the rule-based NegEx algorithm to cover alter-association assertions; the other, Statistical Assertion Classifier (StAC), presents a machine learning solution to assertion classification.

The growing numbers of topically relevant biomedical publications readily available due to advances in document retrieval methods pose a challenge to clinicians practicing evidence-based medicine. It is increasingly time consuming to acquire and critically appraise the available evidence. This problem could be addressed in part if methods were available to automatically recognize rigorous studies immediately applicable in a specific clinical situation. We approach the problem of recognizing studies containing useable [...]