Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Tuesday, January 09, 2018

It Seems Health Information Exchange and Record Location Without A Central Data Base Is Practical and Useful!

This appeared last week:

Strategic Health Information Exchange Collaborative launches new initiative to share patient records nationally

Jan 5, 2018 10:01am
SHIEC's new initiative lays the foundation for interoperability between regional HIEs.
A national trade association for health information exchange organizations has launched a new initiative that allows regional HIEs to share patient medical records across the country.
The Patient Centered Data Home (PCDH), launched by the Strategic Health Information Exchange Collaborative (SHIEC) on Thursday, expands several smaller regional implementations designed to allow HIEs to synchronize patient records and notify physicians when their patient experiences a health event away from home.  
“The HIEs working together to create PCDH built a powerful foundation for interoperability between HIEs—and we managed to do it using our current technologies,” Dan Porreca, executive director for HEALTHeLINK, Western New York's HIE, and chair of the SHIEC board of directors, said in an announcement. “We also created and agreed to a national, legally-binding agreement, which laid the foundation for HIEs sharing data with each other across state lines and throughout communities.”
The national initiative lays the groundwork for medical records to follow patients across the 60 HIEs that make up SHIEC’s membership. When a patient visits a medical facility away from the area where they live, the provider generates an admissions message that includes the patient zip code. Using that information, PCDH notifies the treating physician that previous medical records for that patient are housed in another HIE. Likewise, the system can alert the patient's regular physician that a new record has been generated through a distant HIE.
More here:
Here is the full release with more details:

SHIEC’s Patient Centered Data Home™ Initiative Launches Nationally

Nationwide Expansion of PCDH Lays Foundation for HIEs to Support Better Patient Care by Making It Possible to Share Patient Medical Records Across Geographies

January 04, 2018 09:30 ET| Source: Strategic Health Information Exchange Collaborative (SHIEC)
GRAND JUNCTION, Colo., Jan. 04, 2018 (GLOBE NEWSWIRE) -- The Strategic Health Information Exchange Collaborative (SHIEC), a national collaborative representing health information exchanges (HIEs), today announced the organization’s Patient Centered Data Home™ (PCDH) initiative is now live and serving tens of millions more patients through the network. PCDH is a secure health data exchange system that helps patients by proactively alerting their providers when they have a health event away from home.
The PCDH network makes this possible by synchronizing patient identity records among the several HIEs whose participants are caring for the patient, and it provides detail about where the patient record is located for easier, faster query and response. For patients, this provides reassurance they can receive high-quality, personalized care regardless of where they are in the country.
This national launch unifies three smaller regional implementations in which 17 HIEs worked together to prove the concept of inter-HIE information sharing and notification. Based on the success of the implementations, the participating HIEs have each agreed to a common, national agreement for participation, which set the stage for connecting the regional implementations together and rolling out the full-scale, national implementation.
According to Dan Porreca, executive director for HEALTHeLINK and chair of the SHIEC board of directors, “The HIEs working together to create PCDH built a powerful foundation for interoperability between HIEs – and we managed to do it using our current technologies. We’re very proud of this accomplishment and the milestone we’ve achieved. We also created and agreed to a national, legally-binding agreement, which laid the foundation for HIEs sharing data with each other across state lines and throughout communities.”
SHIEC’s launch of PCDH marks an important milestone in making it possible to achieve health episode notification and efficient data sharing across the country.
What is PCDH?
At its core, PCDH is an inter-HIE notification and data sharing system that allows a patient’s records to follow them wherever they seek care. Because patients are unrestricted by geographic boundaries when they seek care, it is common for a person to be treated by a doctor, clinic or hospital a distance from where they live. Frequently the “away” treatment facility is not a part of the same HIE in which the patient’s “home” doctors participate. As a result, there is a higher risk that the clinician treating them will not have access to the patient’s full medical records to support diagnoses and treatment plans.
To more quickly alert the treating physician that there are medical records available for access from the patient’s doctors at home, and to provide a specific query location to retrieve those records, HIEs worked together to create the technical ability for HIEs to automatically notify each other regarding the existence of a patient’s medical records and to synchronize the patient’s identity among the HIE systems.
The mechanism that makes this work is very straightforward. When a patient presents at a medical facility away from home, that facility will generate an Admission, Discharge, Transfer (ADT) message. This message includes demographics about the patient; information such as the patient’s name, the patient’s location in the hospital, his or her address, phone number, gender, etc. By including ZIP Code information in the ADT, PCDH can automatically detect when a patient is being treated within a ZIP code outside of their normal home area.
When these events occur, the “away” HIE alerts the HIE in the patient’s home area, and that home HIE, known as the patient’s “data home,” automatically lets the treating HIE know they have records for the patient so the treating HIE can generate a query to access those records. Once the treatment encounter concludes, PCDH also makes it possible for the “away” HIE to alert the patient’s home HIE that there are new records for their patient that the home HIE providers can access in order to better care for the patient on an ongoing basis. This new capability makes it possible for a patient’s comprehensive medical history to follow them wherever they seek treatment.
National Approach for Triggering Effective Data Sharing Built on Regional Collaboration
To prove the viability of the PCDH model, SHIEC set up three regional implementations: the western implementation, the heartland implementation and the central implementation. Each of these regional implementations involved coordination among multiple HIEs – which collectively spanned geographic areas and states. The trial implementations were constructed this way to prove the concept worked with multiple different HIE systems.
With the successful completion of the trial implementations and the creation of SHIEC’s national legal framework, PCDH is now being rolled out on a national level. With the implementation of the national agreement, SHIEC has connected the three regional networks into a nationwide network for securely sharing patient information when and where it is needed most to improve health and save lives.
SHIEC is the national collaborative of health information exchanges (HIEs) and strategic business and technology partners. As the unbiased data trustees in their communities, the 60 member HIE organizations manage and provide for the secure digital exchange of data by medical, behavioral, and social service providers to improve the health of the communities they serve. Collectively, SHIEC members serve almost 75 percent of the U.S. population. For more information about SHIEC, visit info@strategichie.com and follow us on Twitter at @SHIEClive.
Here is the link:
I am sure there are some wrinkles in all this but it does rather seem to be a much better way architecturally to solve the mobile patient problem and avoid a great big vulnerable database.
The myHR is looking more like yesterday’s idea as each day goes by!

1 comment:

Peter said...

As a Solution and Enterprise Architect, this is by far the better approach to the problem of Interoperability between systems which are disparate in operation, ownership and capability. A Central control, like MyHR, is simply not as scalable, flexible or extensible.
It works well in Health because the key relationship (between practitioner and patient) happens at the end-points of the systems. And it is probable that almost all interactions are within a well defined region. The need to call records from remote locations is an exception not the rule.
Note that the same concept has already been proven in the financial realm with BPay as the broker. Most interaction are within the same bank with notification passed through the central orchestration system as required.

In Health, I tend to prefer a hierarchy of brokers, for instance at regional, state and national levels, but that is not necessary as long as a shared message structure can be agreed.
One major advantage of the approach is that it can be implemented immediately at a small level - say between hospitals within a particular city - and then incrementally extended as needed. Different regions can even have their own solutions as long as interaction agreement can be reached. And less mature and lower level practitioners can be brought on-board as and when they wish with new message structure and integration arrangements.