Since the coordination of care is supported through the exchange of health infor
ID: 3843343 • Letter: S
Question
Since the coordination of care is supported through the exchange of health information, you have been asked to consult on the development of operational policies and procedures related to a health information exchange (HIE). First, summarize the major architectural models of the health information exchange--making analogies to the various network topologies. Next, analyze at least two operational policies that would support data exchange among the various healthcare entities that utilize the exchange--including outpatient facilities, inpatient facilities, pharmacies, and other health facilties.
Explanation / Answer
There are various conceptual models of HIEs; each presents issues of interoperability, development and sustainability, and privacy and security concerns for health environments, clinical providers and, ultimately, the patient. HIMSS outlines three different clinical data exchange models: Centralized, Federated and Hybrid[1]. In addition there are other models, variations on a theme such as the health record banking model. This section introduces several of the HIE models and briefly presents various business models that they may operate under in general terms.For healthcare organizations considering joining an HIE, there are many hurdles to overcome as well as consideration of the benefits that might be attained. These hurdles include cooperation with potential competitors, development and agreement on technical standards and system functions, infrastructure development, and financing and sharing the ongoing costs to sustain the activity. Consumers and their providers may also have issues in the area of control, privacy and security.
To date there have been many publications indicating the benefits of an electronic health record (EHR) and physician electronic order entry. Many of these benefits are just starting to be proven since the technology is early in its adoption curve. One example of benefits is the reduction of medication errors and decreasing redundant testing. Many studies confirm not only the cost savings of an EHR but the value of the completeness of the medical record for ensuring quality patient care and lives saved.[2] Given the potential of connecting and sharing data across enterprises, the value that HIE provides could be enormous based on current literature.The development of a common framework and standard data model has been in process for some time. There are several common frameworks evolving, including CCHIT conformance criteria for EHR system functionality and the HL7 Reference Information Model (RIM) for data modeling. Many examples of the use of these frameworks exist across the nation. Widespread adoption of these frameworks and standards by vendors has been slowed by the expense of applying them to the established product base developed using earlier technology. Many groups and organizations are driving toward a common framework. Partnerships and a reasonable business model are critical to the viability and sustainability of any HIE. Also paramount is the readiness of a community to support the structure of a health information exchange and all it entails.
The models described below ultimately provides for sharing of clinical information, medications, lab results, imaging studies and demographic data to various stakeholders across multi-stakeholder enterprises and regions for the benefit of improving patient safety, quality and decreasing health related costs in a community.
Examine the various types of Personal Health Records available for use.
Educate consumers on patient-centered health information technologies such as patient
portals, patient safety, patient education and the Personal Health Record. Course outcome assessed in this Assignment:
HI150-5: Examine future technologies important to the management of health information.
PC 3.2: Interact with others in a professional manner using appropriate communication and
presentation skills.