The National Health Information Infrastructure (NHII) is an initiative of the Department of Health and Human Services set forth to improve the effectiveness, efficiency, and the overall quality of health and health care in the United States.

The primary objective of NHII is to create a National Health Information Network (NHIN) which will be the means by which all health information will travel. Its purpose is to enable patients' EHRs to be accessed and added to by all health care providers (with patient permission) electronically, virtually anywhere in the country, via the NHIN. The NHII will be designed to make it possible for Regional Health Information Organizations (RHIOs) to integrate seamlessly into the national network. The information would be protected as it moves through a secured network protected by strict confidentiality protections.

It is a comprehensive knowledge-based network of interoperable systems of clinical, public health, and personal health information that would improve decision-making by making health information available when and where it is needed. It involves the set of technologies, standards, applications, systems, values, and laws that support all facets of individual health, health care, and public health.

Completion for the NHIN is estimated to be 2015. This completion goal falls in line with President George W. Bush's plan for most American's to have electronic health records by the year 2014.

The Dimensions of NHII

There are three dimensions to the NHII:
Image Courtesy of www.atsec.com

  1. The Personal Health Dimension - supports the management of individual wellness and health care decision-making. It includes data about health status and health care in the format of a personal health record, but also other information and resources relevant to personal health. This dimension includes information supplied both by the individual and by their health providers.
  2. The Health Care Provider Dimension - encompasses information to enhance the quality and efficiency of health services for each individual. The Health Care Provider Dimension includes information captured during the patient care process and integrates this information with clinical guidelines, protocols, selected information that the provider is authorized to access, and information from the Community Health Dimension that is relevant to the patient's care. This dimension is relevant in physicians' offices, hospitals, long term care, mental health facilities, etc.
  3. The Community Health Dimension - is comprised of a broad range of information, including population-based health data and resources, necessary to improve public health. Anonymous data could be used for research or other public health purposes.

The NHII Conceptual Model

The image below represents the current conceptual model for the design of a National Health Information Infrastructure. It illustrates different types of information clusters, typically either a peer-to-peer or central repository, that are expeced to make up the infrastructure. The NHII will exist once these different information clusters are linked across a national network.

Image Courtesy of www.biomedcentral.com

Related Terms

National Health Information Network (NHIN)
Regional Health Information Organizations (RHIOs)
Care Data Exchange (CDE)
Local Health Information Infrastructure (LHIN)

Additional Information

HIPAA and the National Health Information Infrastructure by John R. Lumpkin, MD, MPH
Information for Health: A Strategy for Building a National Health Information Infrastructure by The National Committee on Vital and Health Statistics
Transforming Healthcare: The President's Health Information Technology Plan
Achievable Steps Toward Building a National Health Information Infrastructure in the United States by William W. Stead, MD, Brian J. Kelly, MD, and Robert M. Kolodner, MD