SHIEC Patient Centered Data Home™ (PCDH)
2015 (PCDH concept); 2014 (SHIEC)
Allows for the independent community HIEs in 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
The Strategic Health Information Exchange Collaborative (SHIEC) is a nonprofit national consortium of statewide, regional and community health information exchanges (HIEs) and a trade association that assists our member organizations through the exchange of ideas and business practices as well as through public education and advocacy.
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
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 longitudinal patient record.
Enable providers to initiate a simple query to access real-time information across state and regional lines and the care continuum.
Number of live connections and/or participants
PCDH currently has 26 HIEs connected in regional settings; however the member HIEs represent many data source connections in their individual markets. At present, the members of SHIEC provide services to over half of the population of the United States
(As of October 2018)
SHIEC member HIE entities/organizations
As of October 2018, 26 HIEs from the Western, Central, Midwest and Heartland regions of the US.
Costs (Amount and/or Party Incurring Cost)
SHIEC Membership for HIE organizations and Associate Members are $6,000 for a one-year membership and $11,000 for a two-year membership.
Strategic Business and Technology Partner Membership incur membership fees based on their organization’s gross annual revenue. http://strategichie.com/wp-content/uploads/2013/04/SHIEC-2017-SBT-MemberApplication-Update-081817.pdf
SHIEC does not have provisions permitting or prohibiting participants from charging one another fees for transactions made through the PCDH.
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.
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 SHIEC members, and is currently structured as regional efforts (three to-date) 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.
All clinical data becomes part of the comprehensive longitudinal patient record in the patients’ data home, which is the community health information exchange (HIE) assoicated with where the patient resides.
Certification Requirements for Participation
SHIEC has a set of specifications that participants must use to exchange data over the network. With approval of the PCDH Governing Board, additional standards can be added overtime. Regions may have different use cases and take differing technical approaches to enabling exchange among participants of the Region. SHIEC's general interoperability approach is to 1) trigger alerts based on care events occurring in a remote HIO that is pushed to the patient's local or "Home" HIO so that 2) precisely where and when the patient received care, as well as their identity might be accurately resolved and 3) local HIE governance policies are then applied, and if permitted, alerting is delivered to relevant providers, records returned to the remote HIE to support care of the patient and 4) the home HIE can query and receive the final records when the patient is back home.
Interested HIEs must complete the necessary testing before going live within PCDH.
Continue to service the local/regional/state communities in support of the current and changing healthcare landscape
Current Collaboration across Efforts
Community/Regional HIEs make up SHIEC membership and PCDH Regions. (source)