A Framework for evaluating the costs, effort, and value of nationwide health information exchange

Brian E. Dixon, Atif Zafar, J. Marc Overhage

Research output: Contribution to journalArticle

46 Scopus citations


Objective 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 by those engaged in HIE activities. Design Using a literature review and knowledge gained from active NHIN technology and policy development, the authors constructed a framework for evaluating the costs, effort, and value of data exchange between an HIE entity and the NHIN. Measurement An online survey was used to assess the perceived usefulness of the metrics in the framework among HIE professionals and researchers. Results The framework is organized into five broad categories: implementation; technology; policy; data; and value. Each category enumerates a variety of measures and measure types. Survey respondents generally indicated the framework contained useful measures for current and future use in HIE and NHIN evaluation. Answers varied slightly based on a respondent's participation in active development of NHIN components. Conclusion The proposed framework supports efforts to measure the costs, effort, and value associated with nationwide data exchange. Collecting longitudinal data along the NHIN's path to production should help with the development of an evidence base that will drive adoption, create value, and stimulate further investment in nationwide data exchange.

Original languageEnglish (US)
Pages (from-to)295-301
Number of pages7
JournalJournal of the American Medical Informatics Association
Issue number3
StatePublished - May 1 2010


ASJC Scopus subject areas

  • Health Informatics

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