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Commonwell and CareQuality create federated interoperability system
https://www.healthcareitnews.com/news/ehr-interoperability-were-closing-signature-moment
HIE financial models
Hi, I am part of the Business Working Group of the HIE initiative in South Africa. We are developing the financial model(s) for the HIE and would like comments from for the Colleaga community of practice on how other HIE's have approached their financial models. Thanks to you all in advance for contributing!
Erin Gilbart Hi Biddie - hoping others in the community can comment on their experiences directly, but in the meantime, here are a few tools that may be of interest to you. See page 8 of the following paper re: financial models: https://www.colleaga.org/tools/health-information-exchange-hie-business-models-path-sustainable-financial-success
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Erin Gilbart And this study quantified the benefits of an HIE - note that for this HIE, "data accesses produced net financial gains for all providers and payers. Gains, due to HIE, were more significant for providers with more health maintenance organizations patients": https://www.colleaga.org/tools/optimizing-financial-effects-hie-multi-party-linear-programming-approach
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Devanshi Shah Hi Biddie, the tool "Health Information Exchange Return on Investment (ROI) Calculator" may be helpful in terms of providing some cost estimates: https://www.colleaga.org/tools/health-information-exchange-return-investment-roi-calculator
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Biddie Biddulph Thanks Erin and Devanshi, this is most helpful.
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Smart Health open source app development platform
https://smarthealthit.org/ SMART Health IT is an open, standards based technology platform that enables innovators to create apps that seamlessly and securely run across the healthcare system. Using an electronic health record (EHR) system or data warehouse that supports the SMART standard, patients, doctors, and healthcare practitioners can draw on this library of apps to improve clinical care, research, and public health.
Current situation... I am part of the technical working group developing the Health Information Exchange in South Africa. I’m sharing a request for diagrams that pertain to HIE security architecture.
Where I want to go... I need a security diagram with some bullet points of information.
Help I'm looking for...
I’m looking for any security architecture documents that you might have on the Colleaga domain?
Mercedes King , Innovation Sherpa Hi Rachel if you check out this tool on page 7 there are a few diagram templates that may be helpful! https://www.colleaga.org/tools/security-architecture-design-process-health-information-exchanges
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Michiko Nakamura If the tool above doesn’t help trying looking at figures 1,2 and 3 in this tool on Electronic Health Record Infostructure Privacy and Security Conceptual Architecture: https://www.colleaga.org/tools/electronic-health-record-infostructure-privacy-and-security-conceptual-architecture
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Rachel MacIntosh Great thanks those help a bunch! Do you have any more detail on privacy and security requirements?
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Michiko Nakamura Yes there is a great document here with lots of detail on both privacy and security requirements: https://www.colleaga.org/tools/privacy-security-requirements-and-considerations-digital-health-solutions
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Rachel MacIntosh Thank you!
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Current situation... I am part of a working group that is planning for the build phase of an HIE. Several of us would like to know how we can ensure that the Electronic Health Record (EHR) is consistent, conformant and correct at the time of query?
Where I want to go... for example, many diagnostic techniques can be used to assess the same indicator e.g. cholesterol can be measured on-site using a cholesterol meter or by blood work analysis. If this indicator were stored at a summary level of an EHR, by what govern
Help I'm looking for... I am looking for what algorithmic approach is currently applied in HIE implementations in the USA and Canada that identify the reading and most accurately represents the patient's current state?
Mercedes King , Innovation Sherpa Hi Cameron a good place to get started for a basic understanding of these questions is our article on Master Patient Index’s which is the electronic database that holds demographic information on every patient who receives healthcare services. https://www.colleaga.org/article/tools-designing-master-patient-index-and-other-registries or https://www.colleaga.org/article/implementing-master-patient-index will give you more details.
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Michiko Nakamura If you are looking for something more directly related to conformance criteria & EHR usability my colleague Vivek just posted this tool on increasing EHR system usability through standards: Conformance criteria in the HL7 EHR-system functional model: https://www.colleaga.org/tools/increasing-ehr-system-usability-through-standards-conformance-criteria-hl7-ehr-system
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Cameron Yu Thanks, Michiko! And what about governance principles that might help to ensure that the indicator is maintained in the most effective manner?
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Vivek Seth This tool “Achieving Patient Identity Integrity in Health Information Organizations” covers governance challenges that need to be addressed so that HIOs can consistently identify patients in an accurate manner: https://www.colleaga.org/tools/achieving-patient-identity-integrity-health-information-organizations
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Michiko Nakamura There are also a few case studies that may be helpful attached below: Learning from Previous Efforts: The Santa Barbara County Care Data Exchange https://www.colleaga.org/case-study/learning-previous-efforts-santa-barbara-county-care-data-exchange and Improvement in Quality Indicators Processing Report Delivers Real Time and Accurate Clinical Data in Cedars-Sinai Medical Center https://www.colleaga.org/case-study/improvement-quality-indicators-processing-report-delivers-real-time-and-accurate-clinical
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Mercedes King , Innovation Sherpa If it is more of a question of having policies/procedures in place to ensure that clinicians understand the expectations for imputing information and that the EHR system can identify and resolve discrepancies, check out this link: https://docs.oracle.com/cd/E52785_01/doc.51/e53564/ddb.htm
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Cameron Yu Thanks for the help everyone!
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Current situation... I am part of a working group tasked with developing business requirements for an HIE.
Where I want to go... I need to find information on HIE principles.
Help I'm looking for... I am looking for examples of which principles should be incorporated into HIE governance/operations documentation.
Michiko Nakamura Here is a link to a general article on governance and structure that you might find useful: https://www.colleaga.org/article/health-information-exchange-establishing-formal-organizational-governance-and-structure And a link to a tool that might be helpful: https://www.colleaga.org/tools/health-information-management-principles-health-information-exchange Let me know if you need more information.
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Rachel MacIntosh Thanks. I’m hoping to find less technical documentation and more about guiding frameworks for HIE development on the business side of things.
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Michiko Nakamura So more like this?: https://www.colleaga.org/tools/information-governance-principles-healthcare-igphc%E2%84%A2
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Rachel MacIntosh Yes, more like that. Do you know if there are best practice examples in this area regarding which factors should be considered by our working group?
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Michiko Nakamura My colleague Mercedes was able to dig around a bit and locate a well-referenced Governance Framework developed by ONC in the U.S. The four key categories of principles discussed in the Governance Framework include: Organizational Principles: Identify generally applicable approaches for good self-governance; Trust Principles: Guide HIE governance entities on patient privacy, meaningful choice, and data management in HIE; Business Principles: Focus on responsible financial and operational policies for governance entities, with emphasis on transparency and HIE with the patients best interests in mind; Technical Principles: Express priorities for the use of standards in order to support the Trust and Business Principles as well as furthering the execution of interoperability. Check it out here: https://www.colleaga.org/tools/governance-framework-trusted-electronic-health-information-exchange
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Mercedes King , Innovation Sherpa It seems that this is the 'gold standard' approach based on consensus and that it is better to have a guiding framework/principle approach rather than a rigid rule-making kind of approach to HIE governance. I also located another very user-friendly guide that you might find easy to adapt for your working group: https://www.colleaga.org/tools/governance-health-information-sharing-efforts-achieving-trust-and-interoperability-meaningful This guide includes general governance principles that are important to consider such as participation, transparency, representation, effectiveness, flexibility, well-defined and bounded mission, and accountability. See pages 10-11 for some concrete examples from the Health Information Partnership for Tennessee (HIP TN).
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Rachel MacIntosh Thanks this helps me get started. Any chance you have anything specific to patients/consumers?
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Michiko Nakamura Yes, actually based on the guide Mercedes shared above, the following were adapted by the Consumers Union in California, but are definitely applicable to other settings: https://www.colleaga.org/tools/consumer-and-patient-principles-electronic-health-information-exchange-california
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Current situation... I am currently busy with technical specification for an HIE to send to the vendor Community.
Where I want to go... PROPOSED HIE.ZA IMPLEMENTATION ROADMAP AND PHASES so that vendors are able to see the next steps
Help I'm looking for... I am looking for some guidance or examples for this roadmap
Mercedes King , Innovation Sherpa Hi Jack, here are two good tools on Interoperability Roadmaps. Let me know if these help or if you need something else: https://www.colleaga.org/tools/himss-ehr-association-interoperability-roadmap, https://www.colleaga.org/tools/connecting-health-and-care-nation-shared-nationwide-interoperability-roadmap
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Michiko Nakamura Another great tool you may find helpful is the Service-Oriented Architecture (SOA) Roadmap: https://www.colleaga.org/tools/oklahoma-interoperability-grant-service-oriented-architecture-soa-roadmap
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Mercedes King , Innovation Sherpa Here's one more! Starting on page 27 the Phases of the major steps of the roadmap are described, hope this helps: https://www.colleaga.org/tools/health-information-exchange-roadmap-landscape-and-path-forward
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Current situation... Hi, I am part of the Business Working Group of the HIE initiative in South Africa. I have 2 questions for the Colleaga community of practice, and would appreciate your views on these matters.
Where I want to go... We are setting up the legal entity for the HIE and need to cater for the consent management process.
Help I'm looking for... 1. What are the issues we need to take into consideration when setting up the legal entity for the HIE? We are proposing a 'Not for profit' company. 2. What info is out there regarding a consent management process for the HIE and Funders and Payers connecting to the HIE?
Vivek Seth Hi Biddie, here is an article on consent management to get you started. There are lots of useful references linked into this article. I think the third reference “Business and Architecture Considerations for Interoperable Consent Solutions” might be particularly useful for you to check out: https://www.colleaga.org/article/consent-management-health-care-privacy
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Mercedes King , Innovation Sherpa HIE Consent Registry Considerations is another good article to use as a place to start as it is similar to the one Vivek posted containing important links. I think the tool “Patient Privacy, Consent, and Identity Management in Health Information Exchange” specifically, chapter 3: Patient Consent for Health Information Exchange, might have helpful information: https://www.colleaga.org/article/hie-consent-registry-considerations
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Michiko Nakamura Here is a review on the “Identification and analysis of privacy and security related issues that occur when health information is exchanged between healthcare organizations”. This covers some of the issues to take into consideration when setting up the legal entity for the HIE: https://www.colleaga.org/tools/inter-organizational-future-proof-ehr-systems-review-security-and-privacy-related-issues
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Mercedes King , Innovation Sherpa Starting on page 4, consent managment is discuesed in the results of this review: https://www.colleaga.org/tools/architecture-consent-management-suite-and-integration-ihe-based-regional-health-information
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Vivek Seth This covers some examples of how Canada has information governance in an HIE https://www.colleaga.org/tools/information-governance-interoperable-electronic-health-record-ehr
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Mercedes King , Innovation Sherpa Current situation... I'm helping the HIE security architecture group form a detailed diagram Where I want to go... We want security architecture documents that are available to use as a template Help I'm looking for... I am looking for security diagram with some bullet points
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Sequioa Healtheways Connect
The Sequia Project hosts collaborative initiatives, including: http://sequoiaproject.org/ The eHealth Exchange - a rapidly growing community of exchange partners who share information under a common trust framework and a common set of rules. Carequality - a public-private collaborative building consensus among health IT data exchange programs to develop a common interoperability framework enabling seamless exchange among networks. RSNA Image Share Validation - a conformity assessment program that tests the compliance of vendors’ systems using quality standards determined most effective for accurate and efficient exchange of medical images including those used in the RSNA Image Share Network.
Jonathan Weiner opens the Johns Hopkins Symposium on Population Health Informatics
Check out this great video on population health informatics by Professor Jonathan Weiner: Jonathan Weiner opens the Johns Hopkins Symposium on Population Health Informatics
Current situation... I am part of a working group tasked with developing business requirements for an HIE.
Where I want to go... I need to find information on HIE principles.
Help I'm looking for... I am looking for examples of which principles should be incorporated into HIE governance/operations documentation.
Current situation... I am the lead in setting up the organizational structure for a Health Information Exchange
Where I want to go... I’m hoping these documents will include different aspects of the entity itself, shareholders agreements, governance structures etc.
Help I'm looking for... I’m looking for advice/templates/best practice documentation available that can help me through the process
Shlomo Amit Here is a good article on Establishing a Formal Organizational Governance and Structure https://www.colleaga.org/article/health-information-exchange-establishing-formal-organizational-governance-and-structure
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Mercedes King , Innovation Sherpa This tool covers Centralized Models, Decentralized Models and Hybrid Models of governance starting on page 4 of the linked document https://www.colleaga.org/tools/governance-models-health-information-exchange
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Robert Ames Another useful tool may be the HIE Goals and Governance by StratisHealth which covers Integrated delivery networks or health systems, Public-mediated, and Private-mediated governance structures https://www.colleaga.org/tools/hie-goals-and-governance
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Michiko Nakamura A presentation on Information Governance & Data Stewardship for an HIE might help https://www.colleaga.org/tools/information-governance-data-stewardship-hie
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