To encourage the government to enable organizational and governance progress as well as the industry to move forward and begin to develop the tools necessary to successfully sustain infrastructure and clinical IT application adoption, we make the following four organizational and governance recommendations as starting points:
- Communities should assess their readiness for local and regional data sharing by conducting a rigorous review of the technical, clinical, organizational, community commitment and leadership, all critical success factors in building and managing a local health information infrastructure.
- Communities will require a source of activation to catalyze or enforce convening of a health information exchange infrastructure.
- Most management and legal issues faced by communities and individuals in establishing a health information infrastructure, consistent with effective security and privacy protections, can be addressed in the context of existing law and through use of contracts.
- As health information exchange implementations mature, significant issues that are currently poorly understood may require policy and regulatory changes to enable sustainable adoption.
