The role of community health information networks in disease management

A Community Health Information Network (CHIN) is a web-based net of compute r systems which allows the electronic exchange of clinical, financial and a dministrative information among unaffiliated healthcare entities in order t o improve the efficiency and delivery of healthcare in the community. It ac hieves this through a combination of services, products and technology. One field of application in which CHINs can be very effective is disease ma nagement; the aim of disease management is to align patient, provider and p ayer interests in order to enhance quality of care and cost savings. CHINs can be used to effectively and efficiently implement disease management pro grammes through linking disease management systems (i.e. computerised disea se management programmes) with other information systems. The application o f CHINs in the implementation of disease: management programmes has many be nefits including shared data, internal communication, external communicatio n, value-added applications, bonding and marketing presence. However, there are also problems and pitfalls of an architectural and 'emotional' nature. Architectural problems relate to legacy system incompatibility, legacy fun ctionality, external data representation, communications disparity, distrib uted governance, flexibility versus homogeneity, confidentiality, and size and scalability. Emotional problems include personal barriers, community an d ethnic cultural issues, and suspicion between the various levels of care involved in an information exchange process. Many examples of operational CHINs can be found on the Internet. Although m any challenges lie ahead for patients, healthcare providers and healthcare organisations in this field, these examples show that the use of CHINs will influence medical and healthcare practice in a positive way, especially in terms of disease management.