Nationwide Health Information Network Architecture in the United States and the United Kingdom: Solutions for Developing Countries

The National Health Information Network (NHIN) is a network through which all healthcare providers exchange health information. Since the architecture of such a network is one of the most important factors involved in the design of NHIN; this study aimed to explore the experiences of leading countries in the development of NHIN architecture.

In this descriptive-comparative study, the nationwide health information networks of the United States and the United Kingdom were reviewed. A researcher-made checklist was used to collect information. To obtain information, the websites of the Departments of Health in both countries and scientific databases were reviewed. Then, according to the dimensions of the NHIN architecture, the data entered the checklist and examined and compared

The results of the study identified three approaches to the NHIN architecture. The NHIN architecture in the US, which involves connecting regional health information networks had a bottom-up approach.  The network N3 of the National Health Information Technology Program of the UK with a centralized structure had a top-down approach; and a third approach, known as " Middle -out " was recognized.

Each of the approaches used in the NHIN architecture in the studied countries has advantages and disadvantages, but what matters is the choice of approaches directly linked to the structure and nature of the health system of each country. Developing countries should use one of these approaches or a combination of them to design the NHIN architecture, given the centralization or decentralization of their health systems