Interconnectivity of Health Information Exchanges Using Patient Access Number (PAN) (2015)

ABSTRACTThere has been a paradigm shift in the capturing and storage of medical records. Initially, they were stored in a paper-based format, but as time progresses, most medical facilities have migrated to using an electronic format. Both formats of storing medical records create a silo of patient data and limit the expedience of information sharing. There is a dire need for real-time availability of medical records, but this siloed approach dampens the horizon of sharing records. Various medical providers treat patients, and each provider creates a trail of information. Patient information sharing can be very beneficial and is a critical component in delivering continuous care. Health Information Exchanges (HIEs) are a possible solution to the siloed approach of medical records, and fosters information sharing among the various enrolled medical providers. HIEs can aid in a more effective capturing, storing and sharing of patient information. However, there is lack of a consistent design across HIEs: there are varying layouts and designs across organizations, which present barriers for the interconnectivity and ultimately the sharing of medical records. This paper proposes a solution to enhance the interconnectivity of HIEs using a Patient Access Number (PAN).INTRODUCTIONAccording to the United States Census Bureau, as of July 2013 there were around 316 million people residing in the United States (United States Census Bureau, 2014). The number of people per state ranges from 580 thousand to 39 million (United States Census Bureau, 2014). With this growing population, medical facilities need to maintain accurate records while providing excellent healthcare. These providers are also catering to the needs of more patients, which ultimately creates more documentation about diagnoses and medical information.For centuries, medical facilities in the United States (U.S.) have kept paper-based records of patient's medical information. Electronic Health Records (EHRs) have taken over and continue to evolve. EHRs consolidate patient information, such as diagnoses, medications, and test results in an electronic format (The American College of Obstetricians and Gynecologists, 2010). This allows providers to deliver more effective healthcare (The American College of Obstetricians and Gynecologists, 2010). However, a problem presents itself because patients see different medical providers for various reasons: out-of-town sickness, injuries, urgent care, among others. Each facility stores its own records and these are now siloed. This siloed approach of storing patient information prevents medical providers from seeing the holistic view of a patient's medical records. Consequently, Health Information Exchanges (HIEs) are established to facilitate the centralization of patients' records. HIEs provide timely care in emergency situations and can potentially prolong one's life. The use of HIEs makes previously inaccessible data available, resulting in the availability of more complete clinical information. This could improve the quality of healthcare for the patient (Vest, 2009, p. 223).PAPER BASED RECORDS (PBRS)Since the 1920's, physicians have realized that documenting patients' medical visits and history would provide a tremendous value to the physician as well as the patient themselves (Van Fleet, 2010). Once created, these Paper Based Records (PBRs) are stored within the providers' facility. The problem with this approach is that in order for a patient to have their medical records transferred to or shared with a different facility, the requestor has to fill out a request form and wait a surmountable amount of time (Samsum Clinic, 2014). According to the Health Insurance Portability and Accountability Act (HIPAA), patients are entitled to receive medical records within 30 days of receipt of the request (Robert Wood Johnson Foundation, 2012). Some drawbacks of traditional PBRs are misplaced records, illegible handwriting, and slowness of information retrieval and transmission (Pourasghar, Malekafzali, Sabine, & Fors, 2008, p. …