Interoperability refers to the ability of two or more systems to share information and use shared information . Health service authorities realized that health information has to be interoperable and easy to be accessed and shared electronically. Proper use of health information exchange (HIE) facilitates better communication and allows for more coordinated services across health facilities. Effective communication is essential to improve the quality of care and lower the total cost. There are various conceptual models of HIEs; each has its interoperability, sustainability and maintenance, and privacy and security issues .
There are three health data exchange models: centralized, federated and hybrid. Health record banking model is another business model aids in health information exchange. [2,3]. In centralized model; health data are collected from local source and stored in a central repository. Requested data is retrieved from the central repository [2,4]. This model is quicker in responding to users’ quires, and time saver. It allows for better communication and data sharing. Data are available for scientific and logistic use. Problems that are related to this model can be solved internally . However, this model requires strong data coordination for proper data management, data exchange occurs through large central database, huge effort to maintain and update the data. Updating centralized models are difficult and has to be done at one setting rather than incremental updating . Data matching is the major challenge of this model. Accurate matching process between data available at local systems to the central repository should be exercised. Privacy issue is another major concern because as a result of difficult data matching, error in transferring data from local sources to the central repository may result in serious privacy breach. Decentralized or federated model provides organizational control over health data they owned and provides framework for data-sharing and exchange. Organization serves as a data-owner. This model allows for easier data update. Limited access can be given to unauthorized personnel under special circumstances. It gives the ownership of the data to who initiated it. Federated model is controlled by an internal network . The hybrid model is an interaction between centralized and federated scheme. It provides interface engine for which organizations communicate. This model stores key identifiers and requests for the information that is distributed across the network. Identifier is used to gather, store, and transfer health data to the requesting eligible individual/ institution. In this model, partial replication to the central data repository took place. Most of the data are owned by the organization following the federated model scheme . Health record banking model provides the ownership to the consumers who can access their records stored in central data repository. Many believe that consumers’ control over their data resolves privacy issues and reserve HIPPA policies for confidentiality. Supporters suggest that data can be shared with eligible personnel approved by consumers .
The balance between organizational and customer needs and demands and the OSHA and HIPPA regulations is the primary challenge that faces implementation of HIE models. However, collaborative activities between policy makers, health care providers, and consumer is essential to ensure the effectiveness and satisfaction.
- IEEE Standard Computer Dictionary: A compolation of IEEE standard computer glossaries (New York: 1990)
- Topic series: HIE technical models. From the HIMSS guide to participating HIE. HIMSS HIE Guide Work Group. Health Information and Management Systems Society (HIMSS); 2009
- Just BH, Durkin S, Clinical data exchange models: matching HIE goals with IT foundation. JAHIMA 2008;79:2
- Allison MA Matull M. A review of current & emerging HIE architecture models. CalRhio Summer Summit 2007.
Health Information Exchange Model and Standards
By: Muteb H Alshammari; BS., MS., PhD student in Biomedical Informatics