The Strategic Health Information Exchange Collaborative, representing HIEs across the country, is launching nationally its Patient Centered Data Home initiative, a secure data exchange system that alerts providers when their patients have a healthcare event beyond where they typically receive care.

Under the PCDH initiative, HIEs are automatically able to notify each other regarding the existence of a patient’s medical records and to synchronize their identity among participating HIE systems, providing a nationwide network for securely sharing patient information when and where it is needed.

Dan Porreca, chair of SHIEC’s board of directors and executive director for HEALTHeLINK, says the initiative has been in the works for about two years and that the national launch of PCDH is the result of three smaller regional implementations—central, heartland, and western—in which 17 HIEs collaborated to prove the concept of inter-HIE information sharing and notification.

“The HIEs working together to create PCDH built a powerful foundation for interoperability between HIEs—and we managed to do it using our current technologies,” Porreca added. “We also created and agreed to a national, legally binding agreement, which laid the foundation for HIEs sharing data with each other across state lines and throughout communities.”

Dan Porreca
Dan Porreca

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PCDH makes it possible to achieve health episode notification and efficient data sharing across the country, according to SHIEC. When a patient is treated at a medical facility away from home generating an Admission-Discharge-Transfer message, PCDH leverages ZIP code information in the ADT to automatically detect that they are receiving treatment outside of their normal home area, explains Porreca.

“It’s about leveraging tools and technologies that the HIEs already have,” he adds. “ADT alerts are the triggering mechanism for enabling the notification.”

In response, the “away” HIE alerts the HIE in the patient’s home area, letting the treating physician know that there are medical records available for access from the patient’s doctors at home, while provide a specific query location to retrieve those records. At the conclusion of treatment, PCDH also alerts the patient’s home HIE that there are new records for their patient that providers can access.

By synchronizing patient identity records among HIEs whose participants are caring for the patient, Porreca contends that PCDH provides detail about where the patient record is located ensuring easier, faster query and response for cross-state data exchange.

Currently, 17 HIEs are participating in PCDH—each agreeing to a common, national agreement. Now, SHIEC is looking to roll out the initiative nationally.

“We have over 60 HIEs in SHIEC right now, and a majority have expressed a desire and interest to join in,” says Porreca. “The use case that we’re resolving with PCDH is enabling patients’ data to follow them wherever they go anywhere in the country.”

The national launch of PCDH comes at a time when the Office of the National Coordinator for Health IT is developing a framework for “trusted exchange” of electronic health information across networks. Under the 21st Century Cures Act, signed into law in December 2016, ONC is working on a Trusted Exchange Framework and Common Agreement (TEFCA) to support nationwide network-to-network exchange of health data. The agency has received public feedback on the concept of the TEFCA and is expected to publish a proposed rule soon.

David Kendrick, MD, who serves on the board of directors of SHIEC and is chair of the Department of Medical Informatics at the University of Oklahoma, worked with ONC on the agency’s Shared Nationwide Interoperability Roadmap. He believes SHIEC’s PCDH initiative can help achieve the goals of ONC’s roadmap including achieving a learning health system by 2024.

“We have let ONC in on the fact that we’re working on this,” says Kendrick, who is also CEO of MyHealth Access Network in Tulsa. “For the first time, we have the opportunity as a nation to have that learning health system.”

“We are always pleased to see the industry take steps to help providers and patients on the path to interoperability,” said an ONC spokesperson regarding PCDH, adding that the agency is very aware of the work SHIEC has been doing to advance the seamless exchange of health information.

“We’re going to continue to grow this,” concludes Porreca. “We need more HIEs in and more regions.”

Kendrick notes that SHIEC members “cover more than 200 million lives in this country” and that HIEs in Louisiana and Texas “will be coming onboard” the PCDH initiative shortly.

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