Shifts in the architecture of the Nationwide Health Information Network

In the midst of a US $30 billion USD investment in the Nationwide Health Information Network (NwHIN) and electronic health records systems, a significant change in the architecture of the NwHIN is taking place. Prior to 2010, the focus of information exchange in the NwHIN was the Regional Health Information Organization (RHIO). Since 2010, the Office of the National Coordinator (ONC) has been sponsoring policies that promote an internet-like architecture that encourages point to-point information exchange and private health information exchange networks. The net effect of these activities is to undercut the limited business model for RHIOs, decreasing the likelihood of their success, while making the NwHIN dependent on nascent technologies for community level functions such as record locator services. These changes may impact the health of patients and communities. Independent, scientifically focused debate is needed on the wisdom of ONC's proposed changes in its strategy for the NwHIN

Working Families’ Access to Early Childhood Education

In this brief, using data from the Census Bureau, state administrative systems, and a Carsey survey of working parents, author Jessica Carson examines the child care landscape of the Upper Valley of New Hampshire and Vermont and links these findings to a discussion of early childhood education policy and practice. She reports that 96 percent of Upper Valley parents surveyed said child care is necessary in order for them to work. The number of slots offered by licensed (home- and center-based) early childhood education providers in the Upper Valley is 2,000 short of the estimated number of young children whose parent or parents are in the labor force. Further, the cost of licensed care for an Upper Valley family with just one infant is equivalent to 16 percent of median family income, more than twice the 7 percent that the federal government considers affordable. She discusses possible multipronged strategies and policies to address the challenges working parents face accessing early childhood care and education in the Upper Valley and beyond

Long-term care and intermediary structures for frail older people : Switzerland and Germany in comparison

This is a post-peer-review, pre-copy edited version of an article published in [International journal of care and caring]. The definitive publisher-authenticated version is available online at: https://doi.org/10.1332/239788218X15265697287824Long-term care not only includes residential care, home care and familial care, but services ‘in-between’, such as day and night care, temporary (short-term) stays in nursing homes, respite care, and local infrastructure giving informed advice and conveying informal support. In both Switzerland and Germany, the role of such intermediary structures has been debated and affected by social policy reforms. The authors analyse different functions of intermediary structures, discuss their access and use, and show that intermediary structures can have a different impact on care regimes

National Health Information Network: Lessons Learned From the USA and the UK

National Health Information Network (NHIN) is a network in which all health care organizations, government agencies and other health-related organizations are connected to each other to exchange information about health. Due to the necessity of a framework for NHIN development, in this paper, according to the literature review, a definition for NHIN framework was provided, and then the NHIN related projects were reviewed in the United States of America (USA) and the United Kingdom (UK), NHIN and National Programme for Information Technology in the NHS (NPfIT), respectively. The Review of NHIN framework in the countries studied show some similarities and differences in each dimension that are discussed in this framework. NHIN guiding principles in the NHS NPfIT were not regarded or were considered incomplete, compared to the US. NHIN architecture in the US is decentralized while it is centralized in the UK. Based on the review of NHIN framework, these two countries represent important points that can be used in many other countries. However, it can be said that the development of NHIN does not only mean the implementation of national system or systems, or the binding of local health information systems, but It also needs to build on a framework in which many of the issues related to the formation of NHIN would be considered; including the cooperation between government, private sector and stakeholders with regard to local, national and international needs

Outlook Magazine, Autumn 2018

https://digitalcommons.wustl.edu/outlook/1205/thumbnail.jp

Funding Media, Strengthening Democracy: Grantmaking for the 21st Century

Despite the pervasiveness of media, the amount of philanthropic dollars in support of public interest media remains minuscule and, therefore largely ineffective. The report, based on a survey of the the funding sector, calls on philanthropists to embrace a practice of transparency and information sharing via technology, to determine how existing funds are being used and how they can best be leveraged to increase philanthropic impact within the media field

In the Battle for Reality: Social Documentaries in the U.S.

Provides an overview of documentaries that address social justice and democracy issues, and includes case studies of successful strategic uses of social documentaries

China After the Reform Era

China’s reform era is ending. Core factors that characterized it – political stability, ideological openness, and rapid economic growth – are unraveling. In part, this is the result of Beijing’s steadfast refusal to contemplate fundamental political reform. Since the early 1990s, this has fueled the rise of entrenched interests within the Communist Party itself. It has also contributed to the systematic underdevelopment of institutions of governance among state and society at large. Now, to address looming problems confronting the nation, Chinese leaders are progressively cannibalizing institutional norms and practices that have formed the bedrock of the regime\u27s stability in the post-Mao era