As noted, the NCVHS Interim Report on the NHII (in the Appendix) presents the Committee's thinking in some detail, with extensive examples. Here we summarize the structure as conceptualized by the Committee and affirmed by stakeholders. The functions of the NHII can be illustrated by exploring three interactive and interdependent dimensions. (See the figure below.) They are defined by what they encompass, whom they serve, how they are used, and who has primary responsibility for content and control. The dimensions provide a means for conceptualizing the capture, storage, communication, processing, and presentation of information pertaining to the three major groups of users of information for health: consumers, healthcare providers (both individuals and organizations), and communities (local, State, and national). The Committee calls them, respectively, the personal health dimension, the healthcare provider dimension, and the population health dimension.
- The personal health dimension supports individuals in managing their own wellness and healthcare decisionmaking. It includes a personal health record that is maintained and controlled by the individual or family, plus nonclinical information such as self-care trackers and directories of healthcare and public health service providers.
- The healthcare provider dimension promotes quality patient care by providing access to more complete and accurate patient data on the spot, around the clock. It encompasses information such as provider notes, clinical orders, decision-support programs, and practice guidelines.
- The population health dimension (called the community health dimension in the Interim Report) includes information on both the health of the population and the influences on it. The population health dimension makes it possible for public health officials and other data users at local, State, and national levels to identify and track health threats, assess population health, create and monitor programs and services including health education campaigns, and conduct research.
Consumers, providers, and those responsible for population health at all levels use much of the same information; but they do so for different purposes — respectively, to manage personal and family health, to care for patients, and to protect and promote the health of the community and the Nation. All of these groups also have an interest in using information to track the effects of public policy and to engage in efforts to influence it. The role of some key participants in the NHII may cross multiple dimensions. Health plans' activities, for example, are reflected in both the healthcare provider and personal health dimensions. The idea behind the NHII is to push information and knowledge to the point where all these health decisions are made, so the right decisions can be made at the right time.