The Health Record Banking Alliance, an organization founded by physicians and healthcare professionals to promote community repositories and sustainable options for health information infrastructure (HII), has outlined their proposal for a health information exchange (HIE) structure using personally controlled records and a central health records system.
HRBA's whitepaper cites the drawbacks of the current institution-centric community HII based on multiple studies from 2010-2012. The model is "complex, expensive and unreliable," according to the paper. The current system does not uniformly add changes to a patient's record in any sort of central bank; it only goes into clinician's EHR, which means inconsistencies must be resolved in real-time.
The better alternative, HRBA claims, is a patient-centric community HII architecture, which would allow a clinician to request patient records from a health record bank, then store new information in the bank before sending it back. Inconsistencies could be resolved before the patient's records are requested again. The system would allow patients to securely log in and send and receive messages from a provider.
According to the report, "a national system of health record banks can provide a fully capable health information infrastructure for the nation that is simpler, less expensive, more secure, and provide lifetime patient records."
A separate HRBA whitepaper details financial sustainability for health record banks. The HRBA estimates the cost of a health record bank at $8/year per account. Medical information holders would only have to establish one interface for a health record bank--or a clearinghouse connected to various banks.
The HRBA concludes that health record banks would both meet federal requirements for comprehensive and effective electronic patient information while still protecting privacy and making information widely available for clinicians and patients.