Privacy a priority for information exchange

It seems fitting that just before the final privacy rule was released, the National Cybersecurity Center of Excellence announced plans to test tools and technologies to support the secure exchange of electronic health information, especially for small healthcare providers.

As part of the effort, the National Institute of Standards and Technology (NIST) is seeking organizations to provide products and technical expertise to test security platforms for health information exchange (HIE) that will make it easier for small providers to share patient data.

This is the first step for the National Cybersecurity Center of Excellence in the Secure Exchange of Electronic Health Information project, for which NIST has not yet published a start date. The demonstration project aims to develop tools and methods to support the secure exchange of health information, a process which may be especially difficult for small providers that might lack the security infrastructure or expertise of larger healthcare organizations.

The effort also will explore challenges posed by the variety of devices that can be used in exchange, the range of healthcare data exchange standards, concerns about the lack of physical security controls or the ability to circumvent security features, and interaction with a variety of systems in terms of data synchronization and storage.

Public reporting poses similar challenges to information exchange as privacy and security. Research published by the Journal of the American Medical Informatics Association utilized systems dynamic modeling to investigate the project’s complexity in New York and determined several implications that may be helpful to others.

“HIE for public health reporting is a powerful strategy for shaping both short- and long-term policies to promote the health of populations,” wrote lead author Jacqueline Merrill, DNSc, MPH, RN, an associate professor of clinical nursing at Columbia University in New York City. “HIE for public health initiatives are underway in all 50 states, but there have been few evaluation studies that can inform these complex technical implementations.”

New York’s public-private partnership for HIE public reporting resulted in the development of a web-accessible universal public health node to provide these services and demonstrate feasibility in “test” environments.

To examine the factors affecting the public reporting of clinical measures to state public health departments using HIE, researchers collected qualitative data from six public health experts familiar with the HIE landscape of New York. To account for the complexity of HIE, researchers assessed the results using systems modeling techniques, “a computer aided approach that can be applied to evaluation and policy analysis to augment our understanding of complex social, managerial, economic or ecological systems.”

Researchers developed several diagrams mapping the relationships among internal and external factors affecting HIE activity and HIE policy in New York. These diagrams showed, for instance, how a disruption in federal funding caused development of the universal public health node to stall.

Researchers concluded that strong collaboration and careful planning can reduce the risk of encountering challenges through the HIE implementation process.

Beth Walsh, editor

bwalsh@trimedmedia.com