HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More Series. Part 4 of 6.

In the first three posts in this series on Health Information Exchange I discussed thedifferent motivators that are driving health organizations to connect to HIEs, the three different architecture types of HIEs, and the fact that future financial sustainability is a real concern for public exchanges. In this post, I’ll describe some common HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More terms that you’re likely to encounter when researching or discussing HIEs.

One thing to keep in mind when reading about HIEs and how they operate, at least from my experience, is that the terminology is not consistently used by health IT professionals, which only complicates the learning process. For example, you’ll notice below that the definitions for Document Registry and Record Locator Service have very similar definitions, and you’ll often find they are used interchangeably in discussions and in publication. Hopefully these terms provide a foundation to help you better understand the complicated, and always changing, world of health information exchange.

Clinical Data Repository (CDRClinical Document Repository (CDR) enables hospitals to build a life-long health record environment ... More): The database in which patient data is stored. Regardless on the HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More architecture type, each member organization maintains their own CDRClinical Document Repository (CDR) enables hospitals to build a life-long health record environment ... More. Centralized HIEs have a CDRClinical Document Repository (CDR) enables hospitals to build a life-long health record environment ... More that houses a redacted version of the complete patient medical record, which is easily accessible by all member organizations.
Communication Backbone: The method by which data is transmitted within an HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More. Communication methods include secured email, secured FTP, secured Web servicesWeb services are a standardized way of integrating applications. Using open standards, businesses ca... More, and TCP/IPTransmission Control Protocol/Internet Protocol (TCP/IP) is a low-level communications protocol used... More via VPN connection. HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More components that need to be regularly updated may include: Master Person Index, Record Locator Service, CDRClinical Document Repository (CDR) enables hospitals to build a life-long health record environment ... More, and Portals. Part 5 of this series will provide more information on communication methods.

Document Registry:  A document registry is best described as the “patient index” of each patient who has health information that is accessible by the HIE, and contains information where that information is stored. The health standards organization Integrating the Healthcare Enterprise (IHE) has worked at defining document registries, which are available in evolving Web-services technology. You can read the current Document Registry specifications on the IHE wiki page under the heading “Interpreting Web Services Specifications for XDS.b and XCA.”

Master Person Index (MPI): Stores, and cross references, the unique IDID is a coded value data type. The value of such a field follows the formatting rules for a ST field... More for every patient in the HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More.
Portal: Provides independent, personal access to the HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More for the treating physician or for the patient to view and access information, which can include hospital paperwork, appointment information and personal health information.

HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More Participant Identity Management: HIE member providers and networks are verified by node level identity management, as defined by IHE Audit Trail and Node Authentication standards. Node level identity management establishes security measures that, together with the HIE’s security policy and procedures, provide patient information confidentiality, data integrity and user accountability.

Record Locator Service (RLS): Keeps track of all records for a single patient. The location of the RLS varies depending on the HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More architecture type. Centralized HIEs have a common CDRClinical Document Repository (CDR) enables hospitals to build a life-long health record environment ... More housing basic patient demographic information. Typically, a centralized HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More member issues a patient query to the RLS, which locates the correct patient’s data and sends the location back to the requesting organization – all within the centralized HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More.
In Federated and Hybrid HIEs, all patient data is maintained by and “lives” in the member’s CDRClinical Document Repository (CDR) enables hospitals to build a life-long health record environment ... More (not in a centralized location). When the RLS receives a patient query, it must relay all participant organizations, rank the responses, and then return the information to the original requester – a much more complicated process than in a centralized model.

Check back next week for the fifth part of the series. I’ll try to further explain the different communications methods that can be used to send and receive data in HIEs.

Topics in this HIEHealth Information Exchange (HIE) focuses on the mobilization of healthcare information electronical... More series include:

Part 1: Health Information Exchange: What’s the Motivation?
Part 2: Architecture Types
Part 3: Despite Momentum, HIE Sustainability a Concern
Part 4: The Building Blocks of HIEs: A Glossary of Terms
Part 5: HIE Communication Methods
Part 6: HIE Physician and Patient Portals

Additional Resources
Round Table on HIE Connectivity: Real Experiences with Health Information Exchanges
EHR/HIE Interoperability Workgroup Releases Technical Specifications
Meaningful Use, EHR Certification, & Healthcare Integration

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