Why Saudi needs better sharing of health information across providers and across different care segments?

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HIE summary

Why Saudi needs better sharing of health information across providers and across different care segments?
Health information exchange helps doctors, nurses, patients, pharmacists, and others to seamlessly exchange vital medical information electronically with better quality, speed, security, and cost. And as a national health care system it should promote having a national information structure

Framework for strategic action

  1. Goal 1 inform clinical practice

Promote HER adoption
Promote EHR in rural undeserved areas
Reduce risk of EHR investment

  1. Goal 2 interconnect clinicians

Develop NHIN
Coordinate federal health information system
Foster regional collaborations

  1. Personalize care

Encourage use of PHR
Enhance informed consumer choice
Promote use of telehealth

  1. Improve population health

Streamline quality
Accelerate research
Unify PH surveillance

Health information exchange (HIE): the electronic movement of health information across organizations

Health information organization: An organization that oversees and governs the exchange of health-related information among organizations

Regional health information organization (RHIO): A health information organization that brings together health care stakeholders within a defined geographical area

Health information services provider (HISP): is a vendor that provides operational and technical HIE services
HIE Goals:

  1. To share patient data in geographically tight locations

  2. Provide HIT for physicians and rural hospitals in the region to improve exchange of lab results

  3. Enhance ability to exchange data with public health organizations

HIE Architectural models:

  1. Consolidated: Multiple independent enterprises agree to share resources using a central repository

  2. Federated:

  • Consistent database: multiple independent enterprises agree to connect and share specific information managed centrally but with independent repositories

  • Inconsistent database: multiple independent enterprises agree to connect and share specific information in a point-to-point manner

Note: Some believe that federated inconsistent database model offers the best privacy and the most appealing others believe that federated consistent database model is more cost effective just as capable of providing privacy and more capable of providing security

  1. Switch: a service that enables the exchange of information across multiple independent enterprises

  1. Patient management: patients carry their own electronic records or subscribe to a service that enables the patients to direct exchange of data

  1. Hybrid: combination of any of these models

HIE forms:
Three key forms of health information exchange:

  1. Direct exchange: Ability to send and receive secure information electronically between care providers

  2. Query-based Exchange: Ability for providers to request information on a patient from other providers, often used for unplanned care

  3. Consumer mediated exchange: Ability for patients to aggregate and control the use of their health information among providers

HIE services:

  1. Registry and directory service

  2. Person identification service

  3. Record locator service

  4. Identity management security service

  5. Consent management

  • Opt-in: Data may not be exchanged by default unless the individual consents

  • Opt- out: Data may not be exchanged by default unless restricted by the induvial

  1. Secure data transport

Basic HIO services:

  • Alters to providers

  • Consultations

  • Results delivery

  • Health summaries for continuity of care

  • Clinical documentation

  • E-prescribing

Advanced HIO services:

  • De-identification

  • Data warehousing and analytics

  • Billing and clearinghouse services

  • Transcription

  • Coding cycle management

  • EHR hosting

  • Public health surveillance

Hall marks of HIE success:

  • Model for sustainability that aligns costs with benefits

  • Measures the performance in patient care

  • Common set of principles

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