Question

Compare and contrast the federated, centralized, and hybrid models for HIEs. How do they differ and what are their similarities? If you are a manager in charge of selecting an HIE model, how would you choose an HIE model? Which model would you choose and why? (Approximate length: 300-400 words)

Answer 1

Types of HIE models:

• Federated model:

Also known as decentralized model. In this type of model, all the data will stay at the point of service (POS). the participant in this model will be the member who agrees to share the informationwith other members of the organization. The main part of its infrastructure is the RLS (RECORD LOCATOR SERVICE).This is unique to health information exchange because it is subject to privacy requirements and is based on the standards set by ONC.

This model helps in resolving issues regarding data ownership. The participants in this model must ensure that their model is accessed only by other authorized people only.

• Centralized model:

This is also known as consolidated model. Under this model, the data is stored in a single warehouse and participants regularly submit the data while able to view the model through external methods.

Consolidated data under a single system helps in wide data analysis for research purposes. The issues under this model are that it enables the participants to provide the data and there are chances of duplication of data from many providers. Adequate financial resources and good management is necessary for central repository.

• Hybrid model:

The mixture of the above models and where none of them have prominent architecture then it is a hybrid model.

An HIE model can be selected based on its benefits and how far it ensures security of data.

Looking at all the three models, the consolidated model is considered to be the most used model. This is because of its better security control, lower cost. A single standard helps in maintenance of central repository. There are separate security controls, disaster recovery which all need not be replicated throughout.

This type of model is mostly adopted by an HIE that has come out of an existing organizational structure.

Whichever model the organization chooses, it must fulfill its predefined purpose