Health Information Exchanges are typically categorized by how a patients health information is stored and how the legitimate members or participants can access patient health information. Here are common models that are currently being used throughout the country.
Centralized Model – Also known as a Consolidated model. In this model all data is stored in a single warehouse or data repository and participants regularly submit patient data while being able to view the data through external delivery methods.
Decentralized Model – Also known as Federated or Distributed. In this model all data stays at the point of service (POS) and the participant is a member of an organization and agrees to share their information with the other members of the organization. The key to it’s infrastructure is a Record Locator Service (RLS). RLS is unique to health information exchange as it is subject to privacy and security requirements and is based on open standards being set by the ONC. The RLS holds the locators of where authorized health information resides, it however does not hold the actual health information data. In this model there are variations as the independent databases can be consistent or inconsistent.
Hybrid Model – When there is a mixture of these models and none are the prominent architecture, it is considered Hybrid.