The document discusses eClinicalWorks Electronic Health Exchange (eEHX), which connects healthcare providers and allows portable patient records. eEHX uses a web-based platform to give authorized users secure access to patient information like records, lab results, and the ability to send messages. It uses a hub and spoke architecture that can be deployed via software as a service or on-site. Patient consent determines whether their record is shared or private within the system's opt-in/opt-out models at the community or facility level.

1. eEHX
By Avinash Bodare

2. What is Ehx
eClinicalWorks Electronic Health Exchange (eEHX)
connects communities of healthcare providers and
makes portability of patient records possible.
By using modern, web-based technology in community-wide
deployments, the eClinicalWorks eEHX Solution
provides authorized users with secure access to patient
information through an Internet browser.

3. What can be done?
Provider Can:
• View a patient’s Continuity Of Care Records
• View a patient’s Laboratory and Radiology Results
• Import a patient’s Continuity Of Care Data Elements into a
Current Visit’s Progress Notes.
• Send secure messages between Users
• Receive secure messages between Users
Every patient record can either be Health Information Exchange
enabled or disabled based on patient opt-in or opt-out

4. eHX Architecture
eClinicalWorks eEHX is a Hub and Spoke model; each spoke (node) in
the community network uses eClinicalWorks, or another EMR of
customer choice (will be a custom interface with eEHX).
The eClinicalWorks Electronic Health Exchange (eEHX) is a web based
and hosted solution and can be deployed in the SAAS environment or
in a client hosted environment as well.
The eClinicalWorks eEHX service oriented architecture is used to
exchange clinical data within the community and with other health
care providers that deem it useful to receive complete patient clinical
data, to make a more informed decision, and thus hopefully to
provide better quality patient care at the point of service.

5. Diagram 1 below provides a high level conceptual representation of data flow

6. Elements of a Continuity of Care Record (CCR)
The Continuity of Care Record, or CCR, is a standard for the creation of electronic
summaries of patient health. Its aim is to improve the quality of health care and to reduce
medical errors by making current information readily available to physicians at the point
of care.
The elements that are shared in a CCR as part of data exchange are listed below
Data Element Exported to EEHX
Shared between
eClinicalWorks databases
Patient Demographics Yes Yes
Consent Status Yes Yes
Provider Information Yes Yes
Advanced Directive Yes Yes
Past Medical History Yes Yes
Surgical History Yes Yes
Hospitalizations Yes Yes
Family History Yes Yes
Social History Yes Yes
Vital Signs Yes No
Immunizations Yes No
Allergies Yes Yes
Problem List Codes Yes Yes
Problem List Code Notes Yes No
Medications Yes Yes
Procedure Codes Yes No
Laboratory Results Yes No
Radiology Results Yes No
Patient Documents Yes No
Additional Information Yes No

7. What is consent?
• Sharing Patient information is based on the consent
model
• Every patient record can either be health information
exchange enables or disabled are based on patient opt-in
or opt-out.
• Different opt in models
- Community opt in model
- Facility opt in model

8. Community Opt-in Model
• Once a patient agrees to shares his information (consent)
from a particular practice, he automatically agrees to
shares his details for all the practices affiliated to that
community.

9. Facility Opt-in Model
• Once a patient agrees to shares his information (consent)
from a particular practice, his information is limited to
that facility only. Until he again agrees with a new facility.