Nationwide Health Information Network (NHIN) Workforce Study: Final Report. Table II. Proposed Activities, Organization Types and Architecture Types


  1. EHR implementation in provider offices (small, medium, large, very large)
    •             Architecture #1: Each provider has an independent system
    •             Architecture #2: Each provider uses an ASP-model EHR via a browser
  2. EHR implementation in institutions (small or rural hospitals, community hospitals, large hospitals, academic medical centers or hospital chains, long-term care)
    •             Architecture #1: Each institution has an independent system
    •             Architecture #2: Each institution uses an ASP-model EHR via a browser
  3. HII implementation
    •             Architecture #1: All information stays in place and is gathered only when needed (scattered model)
    •             Architecture #2: Each patient’s information is gathered in advance and stored in a health record bank

Categorization of Provider Offices

  1. Small – no practice manager (about one to five physicians)
  2. Medium – practice manager; decisions made by single physician leader (~6–20 physicians)
  3. Large – practice manager and staff; decisions made by committee (~21–100 physicians)
  4. Very large – more than 100 physicians; all have EHRs already so excluded from this study (small number total so minimal impact on workforce estimation)

Categorization of Hospitals

  1. Small or rural – no CIO (25 beds or fewer)
  2. Community – CIO but no staff (~26–149 beds)
  3. Large – CIO and support staff (~150–499 beds)
  4. Academic medical centers or hospital chains – complex decision-making – CIO or CMIO with support staff (medium-to-large number of beds)

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