Healthcare information exchange system based on a Hybrid central/federated model

The quality of care can be significantly enhanced and healthcare cost can be substantially reduced if healthcare providers can have access to patient records that are scattered among several paper and electronic based systems. Major challenges of Healthcare Information Exchange result from patient´s medical records being kept in several healthcare provider offices, clinics and hospitals in different formats. There are two major problems with healthcare information retrieval. The first problem is lack of visibility and knowledge as to where patient´s medical records reside. The second problem is lack of access to information and also incompatibility of data formats. A considerable coverage of Electronic Information Exchange among Electronic Health Record (EHR) systems remains to be implemented despite extensive standardization efforts toward providing solutions. The adoption pace of available standards and solutions has been slow with the exception of some public/government entities. This paper describes a comprehensive and practical solution based on a distributed system with independent subsystems that control and manage processes and data flow of information exchange. The Registrar Subsystem creates a directory of healthcare providers and patients. The Security Subsystem provides authentication and authorization services across all subsystems. The Locators address patient and medical location lookup. The Agents act on behalf of healthcare providers to communicate with other subsystems. The Mediators facilitate information retrieval. The Solution comprises of three levels of participation that allows healthcare providers to join the system easily by starting from basic semi-manual information exchange level and then migrating to a fully electronic and automated information exchange. The Solution is modeled based on variety of standards and protocols used in Internet and other application fields as well as healthcare specific standards and proposals.