U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Health Information Exchange (HIE)  

Health Information Exchange (HIE) Overview

The Health Information Exchange (HIE) is designed to improve coordinated health care of the Native American population. This is achieved through the ability to gather patient history documents from a variety of sources, such as facilities of different types or in varying locations. The HIE provides connectivity to internal facilities and external agencies for the secure exchange of relevant patient data.

The HIE provides a mechanism to produce and display clinical documents across multiple IHS facilities. It provides a mechanism to produce a HITSP C32 (HL7 CCD) extracted from RPMS. The IHE XDS.b infrastructure is used and integrated with IHS MPI. An NwHIN interface that is compatible with the FHA CONNECT Gateway has been established. "Patient Consent" with "opt in" / "opt out" capabilities has been implemented and clinical documents such as the HITSP C32 can be shared over the IHS HIE and NwHIN.

HIE Core Components

Component Description Implementation
XDS.b Registry / Repository Provides "federated" health information sharing model; includes Record Locator Service (RLS). Vangent HIEOS XDS.b
Enterprise Master Patient Index (EMPI) Provides a master patient identifier for patients within the IHS health delivery system. NextGate MatchMetrix
HITSP C32 Generator Produces HITSP C32 documents from RPMS systems and makes them available to the IHS HIE as well as through a web service interface. Vangent / IHS
NwHIN Exchange Gateway Enables health information sharing using NHIN Exchange standards. FHA CONNECT Gateway
Document Source Integration Incorporates several components that accept documents (e.g. HITSP C32) and places them in the HIE. Vangent / IHS
Policy Information Point (PIP) Houses XACML policy documents that describe a patient's information sharing preferences. Vangent HIEOS XDS.b
HIE Viewer Web-based user interface that provides a view of patient health information available in the IHS HIE and over the NHIN. FHA CONNECT / Vangent / IHS
Patient Consent Management GUI Web-based user interface that allows patient information sharing preferences to be managed. Vangent / IHS


An example of HIE components and interactions:
End users will enter and view patient data via the Patient Data Viewer.  Data and documentation entered will be stored in the document registry and repository.  Information will be provided by Patient Identity HL7 messages.

End users will enter and view patient data via the Patient Data Viewer. Data and documentation entered will be stored in the document registry and repository. Information will be provided by Patient Identity HL7 messages.
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