What will it take to create local health information exchange (HIE) systems that fit in with the federal government's vision of local, regional and national health information exchange networks based on standards defined by the Nationwide Health Information Network (NHIN)? The fragmentation of the efforts of groups involved in the actual HIE implementation at the community, local and regional levels is just one of many challenges and obstacles facing those who are trying to meet the government's meaningful use criteria. Here are some others.
Data Models: A technical issue with security implications
Theoretically, health information exchange can be accomplished in a number of different ways. One common model is the central repository, where everyone's health information in a given city or region is cached on a central "health exchange server" which can be queried by individual entities.
Another design is the federated model, where a central "master patient index" is used to match user requests with health data residing in the electronic health records systems of individual hospitals, labs, and doctors' offices. There is a corresponding trade-off between speed and reliability with the central repository model, and potentially greater security and access control with the federated model. In practice, most HIEs will likely use some hybrid of central and federated models in order to achieve a workable compromise
--> CLICK HERE TO READ THE FULL COMMENTARY