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HIEs boost efforts to form nationwide network for sharing patient data

As the healthcare industry seeks to achieve seamless nationwide interoperability, the Strategic Health Information Exchange Collaborative—representing HIEs across the country—sees itself as a critical component of the enabling infrastructure.

SHIEC, which is the largest U.S. consortium of its kind, represents almost 80 HIEs that combined cover more than 92 percent of the nation’s population.

“We have a lot that we do as an HIE community—we are already connected,” says Kelly Thompson, SHIEC’s CEO. “I feel so much responsibility as a leader in this space to work with my colleagues to try to get us to that next level and to make those connections, so we can get to that other 8 percent (of the population).”

According to SHIEC, its members support all four pillars of interoperability including data acquisition and access that facilitate information exchange, as well as delivering the episode-based alerts and meaningful data processes that make it usable in clinical settings.

In particular, SHIEC’s Patient Centered Data Home initiative is connecting 45 HIEs nationwide to seamlessly deliver health information across state lines and across healthcare systems—with more than a billion total event notifications exchanged and serving 177 million patients in PCDH regions.

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Kelly Thompson

“Making sure that everyone has access to their information when and where they need it—that really is the crux of what Patient Centered Data Home (PCDH) is,” contends Thompson. “Arguably, all of the other networks should be focused on that same interoperability mission.”

PCDH makes it possible to achieve health episode notification and efficient data sharing across the country, according to Thompson. When a patient is treated at a medical facility away from home generating an Admission, Discharge, Transfer message, PCDH leverages ZIP code information in the ADT to automatically detect that they are receiving treatment outside of their normal home area

“We have a governance structure in place where we have regions and regional agreements, as well as a national agreement,” notes Thompson. “Data moves at the speed of trust. If people are not comfortable with the way information is being shared, they’re not going to be participating.”

Thompson points to the fact that the Office of the National Coordinator for Health IT is developing a framework for “trusted exchange” of electronic health information across networks. Under the 21st Century Cures Act, signed into law in December 2016, ONC is working on a Trusted Exchange Framework and Common Agreement (TEFCA) to support nationwide network-to-network exchange of health data.

“Many of us have already been doing this anyway—but (TEFCA) takes it up to the next notch,” comments Thompson.

In September, ONC announced that The Sequoia Project will serve as the Recognized Coordinating Entity (RCE) responsible for developing, updating, implementing and maintaining the Common Agreement component of TEFCA, which will create the baseline technical and legal requirements for health information networks to share data.

In addition to the Common Agreement, The Sequoia Project—as the RCE—will collaborate with ONC to designate and monitor Qualified Health Information Networks (QHINs), as well as modify and update accompanying QHIN technical requirements.

In response to these developments at the ONC level, SHIEC issued a request for proposal to industry last month. The RFP is meant to help SHIEC evaluate PCDH’s business and technology strategy to determine whether it needs to offer QHIN services to its membership and if the same infrastructure needed to support PCDH is appropriate to meet the requirements of becoming a QHIN.

Important questions SHIEC is looking to answer through the RFP include: Assuming its member HIEs will need to or desire to participate in the TEFCA ecosystem, should SHIEC offer QHIN services to its membership? And will there be a sufficient market and a business model to support offering QHIN services?

“We’re just starting to tighten the screws a little bit and seeing what that next level is for Patient Centered Data Home, especially in light of the policy changes with TEFCA and the award of RCE,” Thompson concludes.

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