7-1 Final Project Submission

Health Information Exchange Plan
Name
Institution
Health Information Exchange Plan
Issues Experienced by Memorial Hospital
The Memorial Hospital is facing challenges such as lack of proper data systems for storing, retrieving, tracking and disseminating patients’ information. The hospital is unable to monitor patients’ health, even after being discharged from the facilities, as there are no better platforms for doctor-patient distance interactions. The experience has led to further complications such as issues of medical errors because there are no records to refer. As a result, patients get readmitted or have duplicated test due to lack of past medical history, and the treatment process is done as the initial.
Information to Exchange Between Organizations
Health information such as patient referrals, laboratory results or orders and discharge summaries that get directed to another healthcare professional, can be exchanged between agencies. An organization may not be entirely equipped to offer complete treatments, and when there is need to transfer patients, it is essential their data get shared. The information may be sent over the internet, though in an encrypted form for the matter of security (Langabeer, Champagne & Sullivan, 2016). Another type of information that organizations can exchange is that which raises a critical concern such as public health issues. For instance, in case of an epidemic say like virus outbreak, health departments must share information with other units, inclusive of governmental bodies, to protect the citizens.

Information Not to Exchange Between Organizations
On the other hand, Protected Health Information (PHI) is restricted for exchange between health organizations. PHI are data entries in a medical record that can be used to allocate or identify a person (Goldstein, 2014). If such information gets shared and accidentally land into criminal hands, the patients would get subjected to matters of security threats. Info like age, account number, address or patients name is disclosed to a covered entity which is entrusted to use only for providing health care services. Also, information such as blood test results, phone records, schedule of patients’ appointments with doctors and billing information is personal and cannot be exchanged.
Health Information Exchange Model
I would implement a decentralized or federated model in data sharing process, to facilitate access of information only when it is required for the exchange. Health information is very critical and therefore needs a governing platform whereby its retrieval procedures are significantly regulated (Fragidis, Chatzoglou & Aggelidis, 2016). The model would allow the initiators of a health record, like the providers, to maintain the ownership of the medical records while providing access specifically to those authorized. Despite the cost of maintaining this model, information participants will be assured that data is current from multiple clinical data warehouses. Federated model would not provide a room for conflicts of who owns the data since information is locally saved at the point of services.
How to Extract Data from Health Information Systems
I would use a record locator service (RLS) to obtain health records from the federated information exchange structure. Some hospitals, like Memorial Hospital in the case study, are community-based organization serving a considerable population thus requires efficient computerized information systems. RLS is computer services that allow healthcare providers obtain patents’ data electronically (Raghupathi & Raghupathi, 2014). Health records would be located by use of criteria such as the personal identification document (ID), as record locators are the key to this decentralized infrastructure. The RLS is unique when it comes to information exchange since it is a subject to privacy or security measures, and detects which servers contain specific registered data.
Analyzing Data in HIE To Improve Patient Outcomes
I will use predictive analytics methods to evaluate an extensive data entered into the healthcare industry and avail solutions to health problems. By being able to analyze the current and past recorded data using machines, predictions can get done while health providers become able to identify risks and rising opportunities. Again, by referring Information in the HIE networks, the error will be traced and get reduced, and this will improve patients’ safety (Abramson et al., 20114). Data exchange by healthcare professions facilitate effective communication among the providers, and it is through proper interaction that efficient approach to medical problems get established.
Interoperability and Data Dictionary
Classification Standards and Terminologies: understanding the most appropriate classification standards as well as the terminologies that are needed to initiate successful interoperability and security will play an important role in guaranteeing an effective data management approach. In this case, the ISO and Health informatics will be necessary for the successful interoperability and security (Stolc, Wild, Valentin, Daubner & Clabian, 2016). Foremost, ISO is regarded as the world’s largest developer of the voluntary standards with many technical committees. In this case, the ISO/TC 215 Health Informatics will help in developing voluntary standards in communication technology and health information. Also, the health informatics standards (HIM) in the management of electronic data.
Technologies, Legal, Ethical Standards and Regulations: The most important technologies must be put input place to achieve a successful Interoperability as well as Security of the data. The three levels of technologies include foundational interoperability (facilitating information system to exchange data with the other information systems), structural interoperability (defining the formats of the exchanged data), as well as semantic interoperability (facilitating the exchange of information between two or more systems). Both the legal and ethical standards and regulations play important in guaranteeing proper health information (Elkhodr, Shahrestani & Cheung, 2016). The adoption of ethical as well as legal standards will be significantly driven by regulations. In this case, ASTM will be responsible in publishing the standard test methods, terminologies, guides, as well as classifications.
Compliance Standpoint: There exist a broad range of measures that must be put in place to ensure the information about the patient is adequately protected (Stolc, Wild, Valentin, Daubner & Clabian, 2016). The various measures that can be initiated to improve the protection of patient information should include encouraging a security mindset across the organization, making remote competitive, giving patients easy access to their information and positioning HIPPA as a benefit to the organization. Personal health information must be addressed and held considerably as evoked by the federal acts, to ensure complete privacy and confidentiality of all patient information.
Data Dictionary
Data Dictionary: it refers to a set of information that describes the type of data collected or obtained within a database, the formatting, structure and the way it is used. The content of data dictionary will comprise of a broad range of information, which extensively explain the various terms used to be used within the healthcare setting (Stolc, Wild, Valentin, Daubner & Clabian, 2016). For instance, it can provide list of names, definitions or data elements that need be captured in the system, including additional information about each of those elements. Healthcare institution exchange information with the outpatient clinics, pharmacies, and labs. The three types of information to be exchanged may include directed information, query-based information, as well as consumer-mediated information.
Manage and Maintain the Elements in Data Dictionary: there exists a broad range of approaches that the various elements of the data dictionary can be managed and maintained by the users. There are two ways in which elements in the data dictionary are managed; creating data dictionary which includes, at minimum variable labels and descriptions, variable names, allowable values and response options, and the variable types (Elkhodr, Shahrestani & Cheung, 2016). Also, it will be important to constantly clean the data by including duplications, identifying errors, as well as the use of software in identifying and correcting errors.
Importance of Adopting and Using Vocabulary Standards: Some important factors associated with the adoption as well as the use of the already set vocabulary standards to help communicate health reports (Giaffreda, Capra & Antonelli, 2016). Standardized vocabulary will be effective in ensuring there is better communication among staff in healthcare institutions. Data standards supports an effective assimilation of new knowledge into decision support tools like alerting new drug refinements to the care activities. A quality and consistent data ensures patients safety, effective communication of delivery services and health report since it is arranged in systematic procedures understood by health professionals. Terms across the healthcare are well-understood through naming standards.
Data Standardization and Exchange: Standardized data are required for essential flow of information to various interconnected components and interoperative healthcare systems. It is important to have a better understanding the importance of applying the data dictionary to the organization’s information system in supporting data standardization as well as an exchange of information (Elkhodr, Shahrestani & Cheung, 2016). Data dictionary serve as the most effective approach through which healthcare staff can refer to difficult terms. Because of its role, data dictionary will enhance communication within healthcare institutions.
Communication
Stakeholders to be Affected by the Change: As the Greater Manchester County plan to build a Health Access Network, the program will affect many individuals like insurers, government, health providers, consumers or community-based organizations. For instance, community health care professionals such as nurses, health workers, physicians or doctors will be mandated to increase computer knowledge, to work efficiently during patients’ data sharing. The exchange of information via technology programs will be a different technique than other record keeping styles like data books, hence the need to modify medical approaches. Physicians will have a great role in controlling hospital costs, as they are individuals who make decisions regarding resources usage. Adjustments on expenses will become a critical issue for these stakeholders, to accommodate the new technology (Esmaeilzadeh & Sambasivan, 2017). Maintaining distance patients’ health records will be a critical routine by the nurses and other hospital workers, as many individuals will become a potential user of distance services.
The non-governmental stakeholders like health insurance companies will have to improve their funding functions to cater for the expense incurred by data transmissions programs. Practicing health information exchange will require monitoring tools such as health gadgets and communication software which not every individual will afford. To access such communication tools, it will be valuable to incorporate covers. Insurers are cost-effective members and will become essential elements in sustaining medical services through availing resources. Additionally, the government will get involved and affected as stakeholders, since it has a significant concern pertaining population health. When health information exchange plans become costly, the administration will be forced to take measures such as subsidizing services so that every citizen receive better modern treatments. The purpose of government involvement in organizations in most cases is to reduce cost pressure, protect individuals and build a culture of good health.
Other stakeholders to get affected by the Manchester program are policymakers, who establishes a framework within which health services are provided. The hospital changes will compel ministry of health, as policymakers, to come up with practical plans which will facilitate quality delivery of technology services. Usually, policymakers collect and aggregate information from an individual like patients, health providers or payors to develop economic policies (Esmaeilzadeh & Sambasivan, 2017). Similarly, the implementation of Health Information Exchange plan will require the drafting of procedures that will tend to answer questions about determining eligible individuals to receive such health plans. After drafting the policies, it will need a follow-up procedure to ensure that the implemented health programs efficiently work serving everyone involved. Therefore, one action will call for an effect on the other.
How to Communicate the Impact of Change: One way of communicating the changes and its effects in the hospital is by teaming up with the stakeholders at hand. Doctors, physicians, nurses and other health workers will hold an internal meeting at communicated dates via memos or through emails, to be informed about new medical procedures. During the meeting, each profession will get explained about the impacts which new information programs will result in, that way enabling a focused team who understands tasks ahead. In the meeting, with health care providers, the seniors will demonstrate how to receive, share or save information in computer system. Impacts such as errors incurred in case of data mishandling will be revealed as a demonstration to bring an understanding of speculated faults, hence building the emphasis on competency (Abramson et al., 20114). To patients and other external stakeholders like government bodies or insurers, communication will be made through online media such as email or hospital website. The department of information technology at Memorial Hospital will communicate the impacts by posting information in official sites detailing the effects of introduced changes. Once the public assesses the content, they can clarify, comment or give feedback via the same platform.
How to Ensure By-In and Participation from Stakeholders: One way to ensure participation and support from stakeholders are by engaging them in during decision-making process. The contribution of ideas is essential in health organizations, as it brings expensive plans that increase outcome for all. People have different interest, and thus health information exchange programs should be implemented in ways that suit all individuals by necessitating their contributions. When performing data programs, stakeholders need to be permitted to support plans by availing financial aids, as a way to involve them in the developments projects. Additionally, feedback or consumers’ response is beneficial in modifying public strategies. Therefore, by facilitating online communications like social media, it will establish a better relationship with patients, companies or government bodies as stakeholders, ensuring their support and involvement.
References
Abramson, E. L., Kern, L. M., Brenner, S., Hufstader, M., Patel, V., & Kaushal, R. (2014). Expert panel evaluation of health information technology effects on adverse events. Journal of Evaluation in Clinical Practice, 20(4), 375-382. doi:10.1111/jep.12139
Elkhodr, M., Shahrestani, S., & Cheung, H. (2016). The Internet of Things: New Interoperability, Management, and Security Challenges. arXiv preprint arXiv:1604.04824.
Esmaeilzadeh, P., & Sambasivan, M. (2017). Patients’ support for health information exchange: a literature review and classification of key factors. BMC Medical Informatics & Decision Making, 171-21. doi:10.1186/s12911-017-0436-2
Fragidis, L. L., Chatzoglou, P. D., & Aggelidis, V. P. (2016). Integrated Nationwide Electronic Health Records system: Semi-distributed architecture approach. Technology & Health Care, 24(6), 827-842. doi:10.3233/THC-161231
Giaffreda, R., Capra, L., & Antonelli, F. (2016, December). A pragmatic approach to solving IoT interoperability and security problems in an eHealth context. In Internet of Things (WF-IoT), 2016 IEEE 3rd World Forum on (pp. 547-552). IEEE.
Goldstein, M. M. (2014). Health Information Privacy and Health Information Technology in the US Correctional Setting. American Journal of Public Health, 104(5), 803-809.
Langabeer II, J. R., Champagne, T., & Sullivan, S. (2016). Exploring Business Strategy in Health Information Exchange Organizations. Journal of Healthcare Management, 61(1), 15-27.
Raghupathi, W., & Raghupathi, V. (2014). Big data analytics in healthcare: promise and potential. Health information science and systems, 2(1), 3.
Stolc, S., Wild, P., Valentin, K., Daubner, F., & Clabian, M. (2016, August). On Interoperability of Security Document Reading Devices. In Intelligence and Security Informatics Conference (EISIC), 2016 European (Pp. 9-15). IEEE.