Healthcare is faced with numerous challenges including the capacity to share clinical, financial, research and public health information among various organizations. One way to handle this challenge is via the implementation of standards-based solutions like integrating the Healthcare Enterprise (IHE), which defines a technical framework that implements established messaging standards to achieve specific objectives for sharing critical medical information (IBM 2).
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The IHE specifications are implemented by Health Information Exchange (HIE) software, in order to administer the sharing of documents among healthcare enterprises such as clinics, private physicians and public health and research facilities. HIE operates on a flexible architecture that is capable of handling a variety of requirements, since the registry stores metadata containing location information of databases that can be centralized or distributed (IBM 3).
It is important to protect the patient’s health information when developing systems and structures that support the exchange of that information using the HIEs. The HIE is expected to maintain a “trusting and supportive relationship with the organizations that provide data to, and retrieve data from, one another through the HIE” (Scholl, Stine and Lin 7). The development of electronic health records (EHRs) and improvement of the US healthcare system requires secure exchange of electronic health information. A systematic approach is therefore important for successful and secure implementation of HIE. The security architecture design involves: capstone policies, which are developed by an organization that incorporates all requirements and guidance for protecting health information within HIEs; enabling services or services necessary to execute the policies; enabling processes that control the operations; notional architectures used as blue prints to drive the selection of technical solutions and data standards; and technology solutions and standards, which are necessary to implement the notional architecture (Scholl, Stine and Lin 7).
Considerable obstructions to interoperable systems can arise due to the evolving standards by inducing maintenance in every vendor product, causing the consumers to decide between innovation and interoperability. The open source community, such as Open Health Tools, has the ability to share the cost of maintaining evolving standards. Open Health Tools includes: the US Veterans Administration, Canada Health Infoway, HL7, ITSDO, and IBM among others, and their role is to expedite the adoption of healthcare informatics technology (Keckley 5).
Public health interoperability can be seen in the regional and national public health organizations, which are important consumers of clinical data as well as sources of important population reports. These organizations are able to analyze data that is significant to them by leveraging the same technical infrastructure and standards being created and actively adopted worldwide within the clinical domain (Keckley 6).
The governance and operational features that lead to the creation of an HIE model include: the supposed value of the services that it is expected to provide to its customers; the defined policies and processes based on the organizational and hierarchical composition; the operations based on data as well as business and technical architecture; and the financial agreements that generate its revenue stream and capital (Deloitte 4).
It is possible to both improve the quality of medical care and lower its cost with the implementation of HIEs. They are advantageous to patients, providers and payors since they lead to “improved and timely communication and secure patient data exchange, regional collaboration and the abolishment of inefficiencies and duplicate services” (Deloitte 5). The result is better quality of care, less medical errors and improved outcomes for patients. The evolution of HIE faces difficulties from a technical, financial and operational aspect; however, its development and adoption will be assisted by both public and private support (Deloitte 5).
While HIEs need to continuously work on self-improvement, sustainability remains a key concern. UHIN is one of the HIEs, which is evolving and developing, therefore, giving it the ability to provide more services to its stakeholders. The simultaneous development of both telemedicine and remote patient management and HIEs is expected to promote interoperability, since it will allow for the integration of streaming video interactions between physicians and patients and among physicians into EHRs (Reid 121).
Deloitte. “Health Information Exchange (HIE) Business Models.” Deloitte Center for Health Solutions (2006): 3-10. print.
IBM. A Model for Health Information Exchange. Somers, NY: IBM Global Services, 2010. print.
Keckley, Paul H. “eHealthcare—Charting the Future Healthcare Prognosis.” Touch Briefings (2010): 5-9. print.
Reid, P. P., Compton, W. D., Grossman, J. H,. Building a Better Delivery System: A New Engineering/Health Care Partnership. Washington (DC): National Academies Press (US), 2005.
Scholl, Matthew, et al. “Security Architecture Design Process for Health Information Exchanges (HIEs).” National Institute of Standards and Technology (2010): 1-28. print.