scholarly journals Emerging and Established Trends to Support Secure Health Information Exchange

2021 ◽  
Vol 3 ◽  
Author(s):  
Emmanouil G. Spanakis ◽  
Stelios Sfakianakis ◽  
Silvia Bonomi ◽  
Claudio Ciccotelli ◽  
Sabina Magalini ◽  
...  

This work aims to provide information, guidelines, established practices and standards, and an extensive evaluation on new and promising technologies for the implementation of a secure information sharing platform for health-related data. We focus strictly on the technical aspects and specifically on the sharing of health information, studying innovative techniques for secure information sharing within the health-care domain, and we describe our solution and evaluate the use of blockchain methodologically for integrating within our implementation. To do so, we analyze health information sharing within the concept of the PANACEA project that facilitates the design, implementation, and deployment of a relevant platform. The research presented in this paper provides evidence and argumentation toward advanced and novel implementation strategies for a state-of-the-art information sharing environment; a description of high-level requirements for the transfer of data between different health-care organizations or cross-border; technologies to support the secure interconnectivity and trust between information technology (IT) systems participating in a sharing-data “community”; standards, guidelines, and interoperability specifications for implementing a common understanding and integration in the sharing of clinical information; and the use of cloud computing and prospectively more advanced technologies such as blockchain. The technologies described and the possible implementation approaches are presented in the design of an innovative secure information sharing platform in the health-care domain.

Author(s):  
Alice Noblin ◽  
Kelly McLendon ◽  
Steven Shim

Florida began the journey to health information connectivity in 2004 under Governor Jeb Bush. Initially these efforts were funded by grants, but due to the downturn in the economy, the state was unable to support growth in 2008. The American Recovery and Reinvestment Act of 2009 provided funding to further expand health information exchange efforts across the country. As a result, Florida is now able to move forward and make progress in information sharing. Harris Corporation was contracted to provide some basic services to the health care industry in 2011. However, challenges remain as privacy and security regulations are put in place to protect patients’ information. With two seemingly opposing mandates, sharing the information versus protecting the information, challenges continue to impede progress.


2013 ◽  
Vol 15 (3) ◽  
pp. 38-46
Author(s):  
Alice M. Noblin ◽  
Kendall Cortelyou-Ward

Florida began the journey to health information connectivity in 2004 under Governor Jeb Bush. Initially these efforts were funded by grants, but due to the downturn in the economy, the state was unable to support growth in 2008. The American Recovery and Reinvestment Act (ARRA) of 2009 provided funding to further expand health information exchange efforts across the country. As a result, Florida was now able to move forward and make progress in information sharing. Harris Corporation was contracted to provide some basic services to the health care industry in 2011. Since then, the Florida HIE has begun to take shape and information sharing is occurring. The ARRA funding will end in 2014 and the Florida HIE must have a plan to survive into the future. This plan must address challenges such as the recruitment of new users, integration of new services, and ultimately long term sustainability.


2018 ◽  
Vol 25 (9) ◽  
pp. 1114-1121 ◽  
Author(s):  
Jordan Everson ◽  
Julia Adler-Milstein

Abstract Objective Hospitals that routinely share patients are those that most critically need to engage in electronic health information exchange (HIE) with each other to ensure clinical information is available to inform treatment decisions. We surveyed pairs of hospitals in a nationwide sample to describe whether and how hospitals within each hospital referral region (HRR) that have the highest shared patient (HSP) volume engaged in HIE with each other. Methods We used Medicare’s Physician Shared Patient Patterns data to identify hospital pairs with the highest shared patient volume in each hospital referral region. We surveyed a purposeful sample of pairs and then calculated descriptive statistics to compare: (1) HIE with the HSP hospital vs HIE with other hospitals, and (2) HIE with the HSP hospital versus federal measures of HIE engagement that are not partner-specific. Results We received responses from 25.5% of contacted hospitals and 33.5% of contacted pairs, allowing us to examine information sharing among 68 hospitals in 63 pairs. 23% of respondents reported worse information sharing with their HSP hospital than with other hospitals while 17% indicated better sharing with their HSP hospital and 48% indicated no difference. Our HSP-specific measures of HIE differed from federal measures of HIE engagement: while 97% of respondents are classified as routinely sending information electronically in federal measures, in our data only 63% did so with their HSP hospital. Conclusions Despite increased HIE engagement, our descriptive results indicate that HIE is not developing in a way that facilitates information exchange where it might benefit the most patients. New policy efforts, particularly those emerging from the 21st Century Cures Act, need to explicitly pursue strategies that ensure that HSP providers engage in exchange with each other.


2020 ◽  
Vol 29 (01) ◽  
pp. 104-114
Author(s):  
Ursula H. Hübner ◽  
Nicole Egbert ◽  
Georg Schulte

Objective: The more people there are who use clinical information systems (CIS) beyond their traditional intramural confines, the more promising the benefits are, and the more daunting the risks will be. This review thus explores the areas of ethical debates prompted by CIS conceptualized as smart systems reaching out to patients and citizens. Furthermore, it investigates the ethical competencies and education needed to use these systems appropriately. Methods: A literature review covering ethics topics in combination with clinical and health information systems, clinical decision support, health information exchange, and various mobile devices and media was performed searching the MEDLINE database for articles from 2016 to 2019 with a focus on 2018 and 2019. A second search combined these keywords with education. Results: By far, most of the discourses were dominated by privacy, confidentiality, and informed consent issues. Intertwined with confidentiality and clear boundaries, the provider-patient relationship has gained much attention. The opacity of algorithms and the lack of explicability of the results pose a further challenge. The necessity of sociotechnical ethics education was underpinned in many studies including advocating education for providers and patients alike. However, only a few publications expanded on ethical competencies. In the publications found, empirical research designs were employed to capture the stakeholders’ attitudes, but not to evaluate specific implementations. Conclusion: Despite the broad discourses, ethical values have not yet found their firm place in empirically rigorous health technology evaluation studies. Similarly, sociotechnical ethics competencies obviously need detailed specifications. These two gaps set the stage for further research at the junction of clinical information systems and ethics.


2019 ◽  
Vol 40 (3) ◽  
pp. 277-283 ◽  
Author(s):  
Erin Sarzynski ◽  
Mark Ensberg ◽  
Amy Parkinson ◽  
Laurie Fitzpatrick ◽  
Laura Houdeshell ◽  
...  

2013 ◽  
Vol 1 (1) ◽  
pp. e3 ◽  
Author(s):  
Kim M Unertl ◽  
Kevin B Johnson ◽  
Cynthia S Gadd ◽  
Nancy M Lorenzi

Author(s):  
Adi V. Gundlapalli ◽  
Jonathan H. Reid ◽  
Jan Root ◽  
Wu Xu

A fundamental premise of continuity in patient care and safety suggests timely sharing of health information among different providers at the point of care and after the visit. In most healthcare systems, this is achieved through exchange of written medical information, phone calls and conversations. In an ideal world, this exchange of health information between disparate providers, healthcare systems, laboratories, pharmacies and payers would be achieved electronically and seamlessly. The potential benefits of electronic health exchange are improved patient care, increased efficiency of the healthcare system and decreased costs. The reality is that health information is electronically exchanged only to a limited extent within local communities and regions, much less nationally and internationally. One main challenge has been the inability of health information exchange organizations to develop a solid business case. Other challenges have been socio-political in that data ownership and stewardship have not been clearly resolved. Technological improvements over the past 20 years have provided significant advances towards safe and secure information exchange. This chapter provides a general overview of community health information exchange in the United States of America, its history and details of challenges faced by stakeholders. The lessons learned from successes and failures, research and knowledge gaps and future prospects are also discussed. Current and future technologies to facilitate and invigorate health information exchange are highlighted. Two examples of successful regional health information exchanges in the US states of Utah and Indiana are highlighted.


Author(s):  
Alice M. Noblin ◽  
Kendall Cortelyou-Ward ◽  
Ashley Rutherford

The Florida Health Information Exchange has grown over the years since its inception in 2004. Harris Corporation was contracted to provide some basic services to the health care industry in 2011 and this relationship has continued to the present time. As services have expanded, challenges have arisen. With disaster preparedness and business continuity an important part of continuity of care and health information technology initiatives, this paper will consider how a “network of networks” can be of assistance when natural disasters strike.


2007 ◽  
Vol 31 (4) ◽  
pp. 531 ◽  
Author(s):  
Peter Sprivulis ◽  
Jan Walker ◽  
Douglas Johnston ◽  
Eric Pan ◽  
Julia Adler-Milstein ◽  
...  

Objective: To estimate costs and benefits for Australia of implementing health information exchange interoperability among health care providers and other health care stakeholders. Design: A cost?benefit model considering four levels of interoperability (Level 1, paper based; Level 2, machine transportable; Level 3, machine readable; and Level 4, machine interpretable) was developed for Government-funded health services, then validated by expert review. Results: Roll-out costs for Level 3 and Level 4 interoperability were projected to be $21.5 billion and $14.2 billion, respectively, and steady-state costs, $1470 million and $933 million per annum, respectively. Level 3 interoperability would achieve steadystate savings of $1820 million, and Level 4 interoperability, $2990 million, comprising transactions of: laboratory $1180 million (39%); other providers, $893 million (30%); imaging centre, $680 million (23%); pharmacy, $213 million (7%) and public health, $27 million (1%). Net steady-state Level 4 benefits are projected to be $2050 million: $1710 million more than Level 3 benefits of $348 million, reflecting reduced interface costs for Level 4 interoperability due to standardisation of the semantic content of Level 4 messages. Conclusions: Benefits to both providers and society will accrue from the implementation of interoperability. Standards are needed for the semantic content of clinical messages, in addition to message exchange standards, for the full benefits of interoperability to be realised. An Australian Government policy position supporting such standards is recommended.


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