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Health Information Exchanges

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Lecture 7 Health Information Exchanges (Chapter 17) Learning Objectives Health Information Exchanges (HIE) and Users Key Factors in HIE HIE Business Models Driving ... – PowerPoint PPT presentation

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Title: Health Information Exchanges


1
  • Lecture 7
  • Health Information Exchanges
  • (Chapter 17)

2
Learning Objectives
  1. Health Information Exchanges (HIE) and Users
  2. Key Factors in HIE
  3. HIE Business Models
  4. Driving Forces for HIE Development
  5. Obstacles to HIE Development

3
Health Information Exchange
4
Health Information Exchange
  • Electronic movement of health-related information
    among organizations,
  • A process within a state health information
    organization or a regional health information
    organization
  • A bidirectional sharing of patient health-related
    information among providers and other authorized
    healthcare professionals

5
National Health Information Network
  • NHIN provides a standardized, secure, and
    confidential way to link information systems
    together for authorized users to share reliable
    health-related information

6
Users of Health Information Exchanges
  • Individual level enhance personal health
    outcomes
  • Professional level clinical decision making
  • Agency/organization level managing operations
    and quality improvement
  • Public health and national level accreditation
    bodies to evaluate population health, health
    policy

7
Architecture of Heath Information Exchanges
8
Key Issues in Heath Information Exchanges
  • Data storage
  • Master person index (MPI)
  • Record locator service
  • Authentication
  • Authorization
  • Security policies
  • Auditing and logging
  • Standards
  • Scope of services
  • Knowledge of workflow
  • Portals for access

9
Data Storage
  • To enable the aggregation of data from many
    sources
  • Infrastructure models
  • Centralized
  • Decentralized / federated
  • Hybrid

10
Centralized Data Storage
11
Decentralized Data Storage
12
Hybrid Data Storage
13
Master Person Index (MPI)
  • To uniquely identify an individual
  • To match the persons data from many sources
  • Could be a complex identifier with multiple
    identification attributes (name, DOB, address)

14
Record Locator Service
  • A service to search health information that
    matches the identified individual
  • Locator can point to a specific types of
    information / criteria

15
Authentication
  • To identify authentic users to the systems
  • Valid users clinical professionals, public
    health professionals, supporting IT professionals
  • Will include patients in future

16
Authorization
  • Authorized user matrix WHO can access WHAT
    information for WHAT purpose
  • CRUD Function Matrix in database
    Create-Read-Update-Delete

17
Security Policies Procedures
  • Agreement among organizations to share patient
    data (retrieve, reuse)
  • Track requests for information(Require patient
    consent)
  • Opt in vs. Opt out

18
Auditing Logging
  • Keep track all accesses to network services
  • Intentional vs. unintentional
  • Connection vs. disconnection

19
Criteria-based Standards
  • To assure the interoperability and reuse of
    information from many sources
  • Data communication protocols
  • Data content, format
  • Technical compatibility among systems

20
Scope of Services Provided
21
Knowledge of Workflow
  • Data processing procedure (When, Who, How)
  • Patient data types (What, Whose)

22
Portal for Access
  • Different portals for different types of
    information exchanges

23
Health Information Exchange Models
  • Government-led HIE direct government program
  • Public utility HIE with government oversight
  • Private sector-led HIE government as a
    stakeholder for collaboration and advisement
  • Public authority HIE a government created
    nonprofit authority with powers to operate in a
    business-like manner

24
Health Information Exchange Business Models
  • Business models designed for financial
    sustainability
  • Membership fee model
  • Transaction fee model
  • Program and service fee model

25
Driving Forces
  • Reduce data duplication and related costs
  • Reduce discrepancies among information from may
    sources and related fixing costs
  • Provide a uniform holistic picture of the
    patients health to improve care quality
  • Underlying key success factor Electronic Health
    Records (HER) and Electronic Medical Record (EMR)
    must be first broadly adopted/implemented

26
Current Obstacles
  • Size and scope of the project
  • Time / Costs
  • Critical mass of data to be exchange
  • Collaboration between competitors (providers)
  • Technical skills / necessary clinical knowledge
    to use the system
  • Resistance to change
  • Composition and structure of governing agency

27
Future Directions
  • Statewide HIE initiatives have started
  • HIE enabler/readiness (coordinating initiaties)
  • HIE outsourcing/technical partnership (technology
    implementation and services)
  • HIE operator (implementation and management)
  • A national health information network to be build

28
Some References
  • http//www.himss.org/files/himssorg/content/files/
    hie/hie_guidewhitepaper.pdf
  • http//www.himss.org/files/HIMSSorg/content/files/
    RHIO/RHIO_HIE_GeneralPresentation.pdf
  • http//www.health.state.mn.us/divs/hpsc/ohit/hiegu
    idance/hieguide.pdf
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