12/17/2010 | RESOURCES

Service Area Health Info Exchange Resource Guide (SAHIE)

The Maryland Health Care Commission (MHCC) wanted to develop health information exchange (HIE) guidelines for the number of community-centered exchange currently being undertaken or planned throughout Maryland. Such exchanges could be internal to a hospital or hospital system, or could address a community’s needs across organizations. The guidelines would advice these service area health information exchanges, or SAHIEs, on everything from technical decisions to privacy and security considerations. The guidelines would also help SAHIEs ensure they would be compliant with the future plans for statewide HIE. The team of Dynamed Solutions and Audacious Inquiry was chosen to develop these policy guidelines.

The project team began by briefly surveying a group of CIOs from Maryland’s hospitals to determine the current status of their data sharing. The team then organized a workgroup whose members included hospital CIOs and other prominent stakeholders from a range of exchange efforts taking place in Maryland. Based on our previous work with HIEs and our survey of SAHIE activity in the state, the team developed a catalog of important issues to be addressed in the workgroup. In 2008, AI facilitated a consensus driven workgroup meeting where stakeholders came together on a number of key privacy and security issues.

Following an analysis of findings from the workgroup, additional background research, and consideration of our previous experience in the HIE space, the team developed a set of recommendations around acceptable business practices for SAHIEs. The project team worked closely with the MHCC to ensure our recommendations for such exchanges would integrate seamlessly with Maryland’s plans for a statewide HIE.

Our team’s final work product was a resource guide detailing recommended standards, policies, and procedures related to privacy and security. The comprehensive guide also included background knowledge and explanations for how the workgroup arrived at its recommendations. Topics addressed in the guide include:

  • Defining a patient’s right to access information
  • Identifying necessary technical standards for providers to connect to an exchange
  • Creating a communications mechanism for exchanges to ask questions and share lessons learned
  • Determining appropriate secondary uses for data
  • Highlighting technical, financial, organizational, legal, and clinical challenges unique to community sharing initiatives

The resource guide was published by the MHCC early in 2009.