Why Centralized Data Banks Won't Work for Health Information Exchange: A Lightweight Approach to Implementing a Federated Model for HIE

1. Why Centralized Data Banks Won’t Work for Health Information Exchange Rex E. Gantenbein PhD, Senior Member IEEE Center for Rural Health Research and Education University of Wyoming rex@uwyo.edu http://www.uwyo.edu/rex/

2. 2 Centralized Data Management Expensive to maintain Availability depends on central system Complex to ensure timely updates Requires all participants to use compatible EHRs Alternative is “interface engine” Requires ID number for all individuals Complicates interoperability beyond state/region

3. 3 Federated Data Management “Network of networks” Cross-state interoperability scales up Record locator can use public information Local data is stored locally Accessed only when needed for exchange Providers/consumers determine what’s released Data is as up to date as possible Failure of a single system doesn’t affect others

4. Implementing a Federated Model Web services support a lightweight mechanism for exchanging information Support distributing information in a variety of formats Minimize the amount of maintenance to an entity’s interface when others are added Scale well when new systems are connected XML is used to describe a class of a data object and behavior of a program Uses tags to surround the data to define and group data Readable by both humans and computers

5. Implementing a Federated Model Web Service Description Language Describes the functions available and their interfaces Describes the parameters that the functions are expecting as well as the return types File is usually put on a UDDI Directory Server advertising the service Web service runs on an accessible server Service accepts a request for information and returns the requested information Messages are formatted according to the description file