CET+-+Exchange+Profile

Exchange Profile Approach Process
Currently, healthcare providers utilize information systems that are not interoperable for some clinical and administrative processes. The overall sector lacks widespread awareness of the need to invest in and use interoperable EHRs that can support health information exchange. An alternative approach to catalyze Healthcare providers’ use of more sophisticated, interoperable EHRs is necessary because HITECH funding is not available to this sector. The recommended starting point is to leverage federally-required healthcare information exchange documents in electronic format that are electronically submitted by interfacing Healthcare providers and organizations and distilling comprehensive guidance into an exchange profile. It’s important to note that an exchange profile can represent key best practices for providers, vendors and implementers and also serve as a reference guide for early adoption of health information exchange documents.

This non-prescriptive, informative guidance to implementers can be obtained through piloting feedback from implementations and early adopter vendors who implement the requisite information exchanges as outlined by the proposed S&I Framework Workgroup (WG). The approach will be to use existing standards as derived from across the existing S&I initiatives including Transitions of Care (ToC), Lab Results Interface (LRI) and Provider Directories (PD) and recalibrate them as needed. In order for electronic exchange and interaction to occur, healthcare providers must establish both a common format and standardization for exchange documents and a technical infrastructure that enables a uniform approach for clinically relevant data elements.

The data elements will be determined by the type of use cases that will be highlighted as best derived from the S&I Framework Initiative Use Case. The deployment models outlined in the S&I Framework Initiatives should be reused wherever possible, and this profile would further expand in more detail on how these deployment models can directly apply to implementation environments. In addition, the profile will utilize Consolidated CDA and HL7 CCD as the eminent platforms in exchanging patient information.

The WG will subsequently formulate a recommendation for a best practice transport method for implementers and then delve deeper into the privacy and security requirements as part of the implementation environment. The profile’s structure will be identified up front to explicitly determine the framework of actors, roles and transactions for a care transition information exchange. Each transaction will be defined in detail with regards to standards used, data elements transferred, the conditions under which the transaction is required or optional as well as the transport mechanism. Moreover, the Initiatives will develop Use Cases supporting custom tailored user stories with defined information exchanges. Given the parameters of an Exchange Profile, providers will be able to conduct pilots and contribute to an iterative process where the profile is further honed based off clinician feedback and clinical functionality to the extent it will best serve the overall healthcare community.

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