HIM350 Module One Journal

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Southern New Hampshire University *

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350

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Computer Science

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Dec 6, 2023

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1 2-1 Journal: Promoting Interoperability Program Standards

2 Memorial Hospital is the largest trauma hospital in Manchester County. They are experiencing several issues that are affecting the efficiency, coordination, and quality of care. They’ve recently joined the Greater Manchester County board who has plans to create and build the Manchester Health Access Network (MHAN), which will be a health information exchange (HIE) system. The board needs to decide on which conceptual HIE model to choose from while keeping their main goal in mind which is to promote interoperability by using a secure network of EMR systems that will link all the healthcare providers in the region and improve coordination of care (SNHU, n.d.). The Promoting Interoperability (PI) Program was created to push hospitals towards using electronic health records (EHR) systems and they could receive monetary incentives by reporting that they were using their EHR in a meaningful way (Heilman, 2023). As of 2018 they no longer use money as an incentive and instead there is a penalty for not completing PI requirements. So, choosing the appropriate HIE will help the organization meet these requirements. There are pros and cons to each model and even though choosing an HIE is not a “one size fits all,” if the organization’s main goals are kept in mind, then the choice should be relatively simple. There are three types of models for HIE, including centralized, decentralized/federated, and hybrid. When comparing centralized to decentralized HIE models, the centralized HIE will require a larger initial investment but promotes more interoperability than the decentralized model. There are also three different exchanges, including directed, query-based, and consumer- mediated. With the direct exchange, one entity sends data to another entity in an encrypted and secure manner, such as a hospital sending a patient’s treatment notes to a follow-up physician. Query-Based exchange is a type of exchange that is “often used when delivering unplanned care such as ED visits (ONC, 2019). A provider queries, or searches for clinical patient data through a

3 network of providers or a central data repository. Consumer-mediated exchange allows patients to have access to their own health information and also allows the patient to have more control over who and when their PHI is accessed. After comparing each model, I believe the hybrid model will be the best choice, because the data is centralized, so it promotes better security by having data stored in one location and is easier to control the security of one location versus various sites. There are some hybrid models where a centralized repository is “logically segregated so that data of each HIE member is separated from the others, allowing data to be easily removed from the exchange if a participant decides to leave the exchange” (McGee, 2012). The hybrid HIE model also lets participants maintain ownership and control of their data which captures one of the main advantages of the decentralized/federated model. This also provides the benefit of faster response times for data returns because all the data is obtained from one central source and not multiple ones. I recommend the direct exchange for MHAN because it promotes security and enables point to point exchange of health information across different healthcare platforms, including treatment and progress notes, lab results, and intake and discharge summaries. This will benefit MHAN and will help with the issues that Memorial Hospital has with sharing information and coordinating patient care through the care cycle and will help to speed up the time it takes to retrieve their patient’s medical information. The Direct Exchange “was created to specify a simple, secure, scalable, standards-based way for participants to send (push) authenticated, encrypted health information directly to known, trusted recipients over the internet (Oachs & Watters, 2021. p 393.). The Health Information Management text states that the centralized aspect of the hybrid HIE model “makes data available faster and potentially more readily available to patients

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4 through a common patient portal tethered to the HIE instead of one hospital” (Oachs & Watters, 2021). This will help the organizations meet the mandatory requirements of Promoting Interoperability for the objective of Provider to Patient Exchange/Provide Patients Electronic Access to Health Information (Heilman, 2023). The hybrid HIE model satisfies several of Memorial Hospital’s needs, including promoting interoperability, timely retrieval of patient’s medical data, and improved coordination of care.

5 References Heilman, E. (2023, February 17). 2023 Promoting Interoperability Requirements. Medisolv . https://blog.medisolv.com/articles/2023-promoting- interoperability-requirements McGee, M. K. (2012). HIE Models: Security Pros and Cons . GovInfoSecurity. https://www.govinfosecurity.com/hie-models-security-pros-cons-a- 5079 Office of the National Coordinator for Health Information Technology (ONC). 2019. “What is HIE?” https://www.healthit.gov/topic/health-it-and-health-information-exchange- basics/what-hie. SNHU. (n.d.-b). HIM 350 Case Study . Southern New Hampshire University. Retrieved July 8, 2023, from https://learn.snhu.edu/d2l/le/content/1349057/viewContent/25128894/View

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