Question

Explain the three architecture models of health information exchange (HIE). Discuss the advantages and disadvantages of each and the role data ownership plays in each model.

Your initial post comprising a minimum of 250 words should have 2-3 credible/peer-review references.

Answer 1

According to health data answers, health information exchanges are categorized based on the storage and accessibility of health information of patients. Based on this, the three architectural models of HIE are centralized model, Federated or distributed model and Hybrid or private model.
In the centralized model, a single warehouse is used to store the entire patient data and viewed through external methods. Data from various local hospitals are integrated into a regional central authority database. This model is useful in community networks and public health system. The centralized model is used to access vital health information from remote places. Data ownership is unclear in this model and a system failure causes the entire network to break down. The issue with this model is that there are cases of duplication of patient data from multiple providers to the central repository. Another issue is the high cost incurred in the setup and maintenance of the centralized model architecture technology.
In the federated or distributed model, the clinical data repositories are located in remote places. In this model, the major advantage is that data stays at the point of service in the member organization and upon request or agreement (RLS Record locator service), information is shared among the member organizations. This avoids duplication of patient data and health information. Data ownership is clear here and a system failure does not cause the entire system or network to break down. The disadvantage is that there are consistent variations in patient records in various health records stored at various remote points of service. Accessibility of patient data also becomes cumbersome with member hospital requesting the information and getting permission from the data owner.
The hybrid model uses a mixture of the above two models focusing on interoperability as the main advantage. This model is used to link the private hospital systems including physicians and internal databases. Data ownership lies with each individual hospital and the framework or architecture allows interoperability through a private governing organization. Security concerns are a major disadvantage of these hybrid models.

Reference:
Health Information Exchanges. 2017. Health data answers publication
Health Information Exchange: Architecture Types. Corepoint health magazine. Published on Feb 16, 2012