Lecture 7: Health Information Exchange

Electronic medical record (EMR) systems, personal health record (PHR) systems, picture archiving and communication systems (PACS), billing systems, reporting systems, and many other systems being used in patient care and healthcare industry in general need to communicate with each other. At the current stage of health IT, it is not the question if the systems will communicate, it is question how to make it efficient and seamless for users. It is already fact that systems need to talk to each other. It is mandated by the U.S. government as part of the meaningful use initiative.

This week's lecture covers two issues. It briefly describes basic HIE features, architectures, and models. Then it mentions some issues related to data standards and formats used in exchange. The latter is topic of other courses offered as part of GMU's program.

Health information exchange (HIE) can be understood as a verb (the process of exchanging information) or as a noun (an entity that facilitates the exchange -organization or platform).

Figure 1: Health Information Exchange

There are many possible architectures for HIE. Three most common models include: centralized, federated and hybrid approaches. When talking about architectures, one also needs to consider physical exchange of data, communication protocols, data standards, and applications that exchange information. The provided recorded lecture fives insight into these topics.

If the above video does not work, download this file: Lecture Part 1.mp4


There are standards that govern all aspects of health information exchange. From physical network infrastructure, thorough privacy and security, to complex data standards and document formats that are used to exchange entire patient records. In health informatics, although we need to be aware of all the exchanges issues, we mainly focus on standards for storing and exchanging data as well as more complex patient information (clinical documents). Among topics described in detail in other GMU courses are the Unified Medical Language System (UMLS), which among other things is used to integrate many controlled vocabularies, and Continuity of Care Document (CCD), which is an XML-based standard for exchanging clinical documents. These are briefly described in the recorded lectures.

If the above video does not work, download this file: Lecture Part 2.mp4


Rest of the lecture describes CONNECT architecture for HIE, and summarizes the covered topics.

If the above video does not work, download this file: Lecture Part 3.mp4