At MEDITECH, we realize that there is no one correct route for customers to take in their data sharing journey. There are a number of different models through which health care facilities can achieve their individual interoperability goals, and MEDITECH is prepared to assist with these efforts by offering a wealth of technology options designed to suit each organization's short-term and long-term needs. 

"MEDITECH supports several Health Information Exchange models and offers interface suites for each model," says Barbara Hobbs, MEDITECH's manager of EHR initiatives. "Data sharing implementations are highly individualized. We work with each customer to fully understand each account's needs and tailor our interoperability interface suites accordingly. MEDITECH offers a centralized and a decentralized model, as well as a Client Registry/Enterprise Master Patient Index (EMPI) and an External EMPI/Client Registry solution."

Centralized vs. Decentralized Models MEDITECH now supports several health care organizations which are achieving interoperability through either centralized or decentralized methods. When data sharing and the exchange of electronic information among participants is conducted through a centralized data repository, it is called a centralized model. All providers or institutions send their data to a central repository on a periodic basis and view information as needed through external portals, or other forms of data delivery. The Indiana Health Information Exchange (IHIE) is a good example of a centralized model. IHIE is working to create an EHR within the state of Indiana through a centralized data center they control via clinical messages from participating Indiana hospitals.

On the other hand, a decentralized model for exchanging information is used when organizations form an entity and agree to share and exchange patient information as needed from their independent databases. That data stays at the point of service, and the entity maintains a pointer to that information. Typically, these independent databases can reference where external data lives via a Record Locator Service (RLS) or a Client Registry (CR) to coordinate patient identification and the location of patient information.

The decentralized model uses emerging Health Information Technology Standards Panel (HITSP) standards for exchanging information between acute care hospitals using MEDITECH's HCIS and physician practices. MEDITECH currently supports data sharing profiles defined by the Integrating the Healthcare Enterprise (IHE) organization, which include Patient Identifier Cross-Referencing (PIX) and Cross Enterprise Document Sharing (XDS).

"The pilot initiative at South Shore Hospital (S. Weymouth, MA)—which is testing the HL7 Clinical Document Architecture (CDA) and Care Record Summary (CRS) standards for information exchange between acute care hospitals using MEDITECH's HCIS and multiple physician practices using other vendor practice systems—is a perfect example of the decentralized model," says Hoda Sayed-Friel, MEDITECH's vice president of marketing. "South Shore is the first pilot phase of Community Hospitals and Physician Practice Systems (CHAPS), a leading example of the federated-decentralized model for data sharing. The entities involved in CHAPS are considered early adopters of emerging industry standards." As reported last month, South Shore Hospital went LIVE with its first phase of a multi-phased project on the scheduled date.

Client Registry/Enterprise Master Patient Index (EMPI) and External EMPI/Client Registry
Additionally, MEDITECH offers Client Registry/Enterprise Master Patient Index (EMPI) and External EMPI/Client Registry solutions. A Client Registry/EMPI solution allows organizations the option to put an EMPI or Client Registry solution in place for patient identification management within their health information exchange. All participating registration systems will look to this EMPI, which can be a MEDITECH or non-MEDITECH solution, to obtain patient demographic information based upon several identifiers. This solution is deployed at MEDITECH customers Inland Northwest Health Systems (Spokane, WA) and Parkview Medical Center (Pueblo, CO).

A central Master EMPI/Client Registry solution manages patient identity and demographic information across multiple organizations and systems. MEDITECH has developed a solution that integrates lookups into the EMPI system as part of its registration workflow. This enables an organization to find a patient that is not found within the local MEDITECH MPI. The Newfoundland and Labrador Centre for Health Information (NLCHI) has successfully implemented Canada's first provincial health Client Registry (also known as an EMPI), which holds accurate demographic information about all people using health services throughout the province.

More Solutions, More Choice
For hospitals interested in communicating results to multiple physician practice EMRs, MEDITECH also has a solution for them. Working with our affiliate Forward Advantage, we offer the Data Express electronic reports interface solution, which provides a rapid deployment model using HL7 standards-based outputs from MEDITECH Laboratory, Imaging and Therapeutic Services, and Departmental applications. What all of MEDITECH's interoperability offerings have in common is they can be easily adapted to suit a wide range of customer needs and goals. 

"Whether you're in the beginning stages of deploying a strategic interoperability plan or in the middle of C-level discussions with other health care organizations, let MEDITECH know your needs, so that we can individualize your data sharing implementation and tailor our interoperability interface suites for you," says Hobbs.