Health Information Exchange Model

An HIE is a Health Information Exchange in which various health information for patients can be stored and viewed electronically by various participants depending on the model used. Participants include patients, physicians, insurance companies, and other users authorized to view a patient’s information. There are three basic models of HIE: centralized, decentralized, and hybrid.
A centralized, or consolidated, model is one in which participants that can upload and view information. It is a centrally located warehouse that will keep the information stored in a singular electronic storage location. Authorized participants can access the information from an external location. This model provides the easiest use because information is
Directed exchanges allow providers to exchange information strictly and securely between each other in order to effectively coordinate care. If a patient was referred by a primary care doctor to a specialist, that primary care doctor and specialist could freely and securely communicate data related to that patient’s care. Query-based exchanges allows for providers to request information for patients outside of their direct or referred care. For instance if a patient chose to change providers, the new provider could send a request records from the previous provider. Consumer mediated exchanges put the patient directly in control of their medical record information. A patient portal available through an online EHR system would allow patients direct access to their records and allow them to share, track, and correct their own information as
The quality of information involves how correct it is. Therefore, data integrity and quality of an HIE involve the dependability of its accuracy. A critical element to Health Information Exchanges is patient identification. Access to and transfer of correct data will assist in ensuring quality care for the patient. Record duplication poses another problem and hazard for quality patient care. The use of algorithms can assist organizations and exchanges in ensuring data integrity and quality. A basic algorithm will compare data based on matches of certain pieces of information such as name, birthdate, etc. The “wild-card” is an example of a basic algorithm. For example, when searching for names using the wild card algorithm, the first three letters in a last name can be entered along with a specified character, such as an asterisk, and the search will return any number of records attached to last names beginning with those three letters. With an intermediate algorithm, other unique identifiers are attached for a more complex search. These searches will yield slightly more specific results such as last names and first names that can be used as either/or (i.e. David, John, etc.) along with names that have been shortened to nicknames attached to identical birthdates. The most complex algorithm allowing the most specific results is the advanced algorithm, and generally involves artificially