Patient Centered Data Home® (PCDH)

Ownership

Non-profit

Governance

Allows for the independent regional and statewide HIEs that are members of Civitas Networks for Health (formerly known as the Strategic Health Information Exchange Collaborative (SHIEC)) to maintain their autonomy and governance while gaining economies of scale. The key issues of disparate data use agreements, policies and patient privacy and consent models are overcome in this framework of patient data exchange

Geographic Reach (within US)

Regional/Nationwide

Mission

Civitas Networks for Health is a national collaborative comprised of member organizations working to use health information exchange, health data, and multi-stakeholder, cross-sector approaches to improve health. We were previously known as the Strategic Health Information Exchange Collaborative and the Network for Regional Healthcare Improvement. We represent more than 150 local health innovators from across the US, moving data to improve health outcomes for more than 95% of the U.S. population. Civitas educates, promotes, and influences both the private sector and policy makers on matters of interoperability, quality, coordination, health equity, and cost-effectiveness of health care. Working with health innovators at state and local levels, we facilitate the exchange of valuable resources, tools, and ideas—and offer a national perspective on upcoming standards and regulations, emerging technologies, and best practices.

How does this approach facilitate exchange?

PCDH enables the exchange of patient information across HIE organizations. Patients are assigned a "home HIE" based on zip codes associated with an HIE. This exchange depends on triggering episode alerts that notify the home HIE of an event that occurs outside the patient's residing region. This trigger alert enables the non-home HIE and the home HIE to share relevant patient information to coordinate better patient care.

Access Method (Use Cases)

Peer-to-peer push and/or query-based exchange triggered by automated notification of care event.

Primary Goals/Objectives

Civitas Networks for Health:

• Improving care coordination and care management across disparate health care systems and the health care community 
• Enabling more informed clinical decision making through more comprehensive patient records and near real-time notification of health care events and results
• Aggregating better information and analysis through cross-system risk stratification and population health analytics 
• Eliminating unnecessary or duplicative tests and procedures, and reducing hospital readmissions and other preventable expenditures.

Patient Centered Data Home™ (PCDH):

• Notify providers a care event occurred outside of the patients' "home" HIE.
• Confirm availability and location of clinical data. Transmit all relevant clinical data for "away" care event and to "home" HIE to contribute to a longitudinal patient record.
• Enable providers to initiate a simple query to access real-time information across state and regional lines and the care continuum.

Type

Patient-centric network

Number of Live Connections and/or Participants

PCDH currently has 45 HIEs connected in regional settings; however, the member HIEs represent many data source connections in their individual markets. At present, the members of Civitas Networks for Health provide services the majority of the population of the United States.

(As of August 2022)

Members

Civitas Networks for Health member HIE entities/organizations

Primary Participants

As of August 2022, 45 HIEs from the Western, Central, Midwest, Heartland, and Eastern regions of the US.

Costs (Amount and/or Party Incurring Cost)

Civitas Networks for Health Membership for qualified HIE organizations start at $7,000 per year, and increase based on organizational revenue.

Strategic Business and Technology Partner Membership incur membership fees based on their organization’s gross annual revenue.

Civitas Networks for Health does not have provisions permitting or prohibiting participants from charging one another fees for transactions made through PCDH.

Directory/MPI Details

PCDH does not maintain a central record locator service, the member HIEs transmit clinical based upon the zip codes that they serve, providing a simple method for record location, without extensive record maintenance/archival.

Standards Leveraged

Technical Standards: ADT Push, CCD Push, CCD Query (XCA)

Zip Code Surveillance standards: Synchronized MPI’s around a specific patient 

ADT Standards - content

Targeted XCA Query – event certainty and patient certainty

IHE profiles & HL7v2

Onboarding Process (Requirements to connect)

PCDH is an initiative solely with Civitas Networks for Health members and is currently structured as 5 regional efforts where policies and trust agreements have been outlined between participating HIEs.

As of August 28, 2017, at the national SHIEC conference, a National Master Collaboration Agreement was released to allow all PCDH Regions to exchange with each other. This National Agreement provides national governance, sets national standards, policies and procedures for i) technical specifications, ii) national use cases and permitted uses, and iii) other needed policies and procedures to operate national structure.

Data Persistance

All clinical data becomes part of the comprehensive longitudinal patient record in the patients’ data home, which is the community health information exchange associated with where the patient resides.

Certification Requirements for Participation

Participation requirements are governed by the PCDH National Master Collaboration Agreement.

Testing

Interested HIEs must complete the necessary testing before going live within PCDH.

Future Plans

Continue to service the local/regional/state communities in support of the current and changing healthcare landscape

Current Collaboration across Efforts

Regional and statewide HIEs and Regional Health Improvement Collaboratives make up Civitas membership and comprise the PCDH regions.

Patient Centered Data Home® is a registered trademark of Civitas Networks for Health Association. Used with permission.