Health Information Exchanges:
The Health IT Inside

CMIO Magazine
November/December 2009

Healthcare officials in Washington are discussing standards for the technical architecture of modern health information exchanges. And while such standards haven’t yet been finalized to meet the objectives of meaningful use of electronic medical records, the U.S. government starts doling out $564 million in grants to states in early 2010 to fund state-level networks for exchanging electronic patient information.

Making wise choices about technical architecture is crucial for HIEs because they impact not only the general connectivity among exchange participants, but also important areas such as the security of patient data and the financial sustainability of the network. Several organizations around the country are embracing the benefits of web services and service-oriented architecture (SOA) for their HIEs. These architectures offer HIEs the ability to efficiently expand services over time as well as the flexibility to tie into larger statewide and national health information networks.

At the Brooklyn Health Information Exchange (BHIX) in New York, which facilitates patient data sharing among six hospitals and seven nursing homes in Brooklyn and beyond, the vision is to eventually adopt a complete web services model, according to Irene Koch, executive director of the regional health information exchange (RHIO). “We wanted something flexible, standards-based, and malleable because we know that in this industry things are going to be changing all the time,” Koch says. A goal for HIEs in New York is to be able to connect to an emerging statewide health information exchange known as the State Health Information Network for New York, or SHIN-NY, which is also embracing web services and SOA to connect to HIEs across the Empire State.

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