Running Head: THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 1 THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 9 The Health Information Exchange (HIE) in U.S Yehyun Park Purdue University 01/02/2019 The impetus of Health Information Exchange in U.S Health Information Exchange (HIE) is an information system that promotes a secure sharing of critical information as well the inclusive access critical medical information about a patient electronically (Abdelhak et al, 2014). One merit of the use of such electronic systems in the U.S is that they occur in different verities. The HIE also offer different types of services. Evidently, a recent development has enabled the HIE systems to promote the Marketplace and regional institutional services concerning the health sector. The merit of HIE applications included the improvement of speed, Quality, safety and reduced relative prices of charge per patient for care. This is made possible by the quick sharing of critical information among the doctors, pharmacists, nurses among all the relevant health personnel. The HGIE systems are such that, they are technically enabled to provide quick response to information demand with the relevant urgency and thus aids in the making of vital patient’s data and medical progress devoid of medical errors, readmissions, and duplicate testing. The resulting system has a generally improved diagnosis. HIE enables three line of services in general: directed exchange, Query-based Exchange a consumer-mediated exchange services. Direct Exchange is the sending or receiving data electronically in the aid of coordination by caregivers. Whenever heath care provider wants to consult with other providers about a planned care, they employ the Query-based exchange while consumer-mediated Exchange enables patients to manage through control of the use of their personal information (Abdelhak et al, 2014). The availability of the three forms of health information Exchange makes the strong point of HIE since their integration in use is guided by some predetermined policies, technology, principles, and policies provision which have already been piloted before. The three forms are completely available throughout. With the Consumer-mediated Exchange system, the patient can be able to monitor the use of his personal medical information by their care provider. The patients can make a participation in their care enhancing through providing alternative providers with their heath condition, describe their heath information give the health missing or incorrect information, track and manage their own health. Describe basic HIE organizational structures, architectures, and services The commonly known architecture types of HIE includes the centralized hybrid and the federated models of HIE. The centralized HIE model is enabled with one Clinical Data Repository (CDR). The CDR is managed by HIE authority that is under the governance of the representatives from the relevant hospitals (Abdelhak .

1. Running Head: THE HEALTH INFORMATION EXCHANGE
(HIE) IN U.S 1
THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S
9
The Health Information Exchange (HIE) in U.S
Yehyun Park
Purdue University
01/02/2019
The impetus of Health Information Exchange in U.S
Health Information Exchange (HIE) is an information system
that promotes a secure sharing of critical information as well
the inclusive access critical medical information about a patient
electronically (Abdelhak et al, 2014). One merit of the use of
such electronic systems in the U.S is that they occur in different
verities. The HIE also offer different types of services.
Evidently, a recent development has enabled the HIE systems to
promote the Marketplace and regional institutional services
concerning the health sector. The merit of HIE applications
included the improvement of speed, Quality, safety and reduced
relative prices of charge per patient for care. This is made
possible by the quick sharing of critical information among the
doctors, pharmacists, nurses among all the relevant health
personnel. The HGIE systems are such that, they are technically
enabled to provide quick response to information demand with

2. the relevant urgency and thus aids in the making of vital
patient’s data and medical progress devoid of medical errors,
readmissions, and duplicate testing. The resulting system has a
generally improved diagnosis.
HIE enables three line of services in general: directed exchange,
Query-based Exchange a consumer-mediated exchange services.
Direct Exchange is the sending or receiving data electronically
in the aid of coordination by caregivers. Whenever heath care
provider wants to consult with other providers about a planned
care, they employ the Query-based exchange while consumer-
mediated Exchange enables patients to manage through control
of the use of their personal information (Abdelhak et al, 2014).
The availability of the three forms of health information
Exchange makes the strong point of HIE since their integration
in use is guided by some predetermined policies, technology,
principles, and policies provision which have already been
piloted before. The three forms are completely available
throughout. With the Consumer-mediated Exchange system, the
patient can be able to monitor the use of his personal medical
information by their care provider. The patients can make a
participation in their care enhancing through providing
alternative providers with their heath condition, describe their
heath information give the health missing or incorrect
information, track and manage their own health.
Describe basic HIE organizational structures, architectures, and
services
The commonly known architecture types of HIE includes the
centralized hybrid and the federated models of HIE. The
centralized HIE model is enabled with one Clinical Data
Repository (CDR). The CDR is managed by HIE authority that
is under the governance of the representatives from the relevant
hospitals (Abdelhak et al, 2014). The hospitals located within
the same metro area or within the same region can utilize the
centralized model. a patient health agreed issues are retained
and maintained in the centralized system with regular updates
via interfaces. The information transmitted electronically with

3. the customer's consent within all member hospitals. The
structure of the regional model is as shown below in figure 1.0
Figure 1.0 Regional Central Authority (Abdelhak et al, 2014)
On the other hand, involves the collection and combination of
all information repositories collected from several centralized
models. Here the unique patient’s identifier data are collected
from the centralized model and harmonized in a central
authority. The patient’s information is stored in inaccessible
locations and featured by unique patient’s identifiers which play
an important role in the virtual roadmap. The national HIE
model is a more complex combination of several federal HIE
models. The models contain Patient’s identifiers and are
typically called NwHIN. It uses the basic features of the
federalized models in the management of patients’ information.
The figures1.1 and 1.2 below shows the federalized and the
national models respectively.
Figure 1.1: Federalized HIE Model (Abdelhak et al, 2014)
Figure 1.2: Nationalized Model of HIE (Abdelhak et al, 2014)
The basic services offered by the HIE systems includes the
registry and directory aid, identity management, management of
consent, administering security to data transport, person and
entity identification and record locator services as well as
search services for data (Abdelhak et al, 2014). Other services
include the De-identification and the aggregation, data
warehousing and analysis, data exchange and “add on” business
lines services.
Explain why data stewardship in HIE services in import
Database management is the fundamental aspect that determines
a firm’s power for future referential performance. Healthcare
provides services in prerequisite approaches and thus a past
diagnose is a reference to a future treatment. For this reason, it
is much necessary for caregivers to practice data stewardship so

4. as to maintain honest data and security from loss. Data
stewardship in health sector enhances true records for future
reference, simplified processes and thus saves of resources.
Similarly, much time is saved from the loss when data is saved
from loss since no much is spent in recovery. There is need to
ensure better management strategies to regulate on the data
access and handlers in the HIE systems. This is important since
the health institutions deal with personal health information
which should be accorded necessary privacy. This is in most
cases enhanced through the seeking of special patient’s consent.
The HIV/AIDS status, mental illness, and other sexually
transmitted diseases information are sensitive health record
which can only be shared with the patient's consent ad must
comply with the requirements of HIPAA. For this reason, data
access is regulated and with respect, faithfulness and honesty,
failure to which implies offending the rights of the patient. The
security and private provision of the Health Insurance
Portability and Accounting Act (HIPAA) must be complied with
in the handling of patient’s information(Abdelhak et al, 2014)
.
What Activities Should Be Employed to Achieve the Benefits
Of HIE Systems and overcome the related challenges
For a user to achieve the benefits of the HIE in the health
sectors, the privacy of the patients’ information must be ensured
and only with relevant consent should sharing be done. Correct
data analysis should be conducted before making significant
reference. All activities conducted should comply with the
provision of HIPAA. Similarly, data security and backup
strategies must be ensured to avoid loss of critical information.
We also must set the database access policies and implement
them accordingly and set the appropriate limit of information
use. The care providers must also ensure openness and
transparency, apply data integrity and quality principles and
observe use limitation (Abdelhak et al, 2014)
. To overcome the challenges of the HIE users can do the
following: ensure there is a reduction of the cost of

5. administration, manual data and the costs of paper-basic
systems either by avoiding unnecessary hospitalization,
avoiding redundant testing and making more efficient testing.
Caregivers should improve the patient care coordination and
conciliate effective medication. This will solve the challenge of
data handling management.
Nationwide Health Information Network (NHIN)
Nationwide Health Information Network is a standard set,
policy guideline and a limit spell that enable the health
information exchange (HIE) in its internet application. NHIN
regulates the exchange and sharing platform for health
information through diversified entities. The policy guidelines
are used by the federal Healthcare providers and the exchanges
of health information at the federal level and the local levels.
They direct the actions of information sharing in the national
level by creating a secure panel that supports both the privacy
and the security of the confidential data. The NHIN regulations
control the data sharing on the basis of language, vocabularies,
certification, authentication, vocabulary, and the delivery
protocol. NHIN also checks on the message standards and
ensuring directories as well as a trust security and framework
for data management.
Reference
Abdelhak, M., Grostick, S., & Hanken, M. A. (2014). Health
information: management of a
strategic resource. Elsevier Health Sciences.
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