Health Information Exchange (HIE) Security Architecture

The secure exchange of electronic health information is important to the development of electronic health records (EHRs) and to the improvement of the U.S. healthcare system. While the U.S. healthcare system is widely recognized as one of the most clinically advanced in the world, costs continue to rise, and often preventable medical errors occur. Health information technology (HIT), especially the development of electronic health records for use in both inpatient and ambulatory care settings, has the potential for providing reliable access to health information and thereby improving the healthcare system. However, the prospect of storing, moving, and sharing health information in electronic formats raises new challenges on how to ensure that the data is adequately protected.

Protecting electronic patient health information is crucial to developing systems and structures that support the exchange of that information among healthcare providers, payers, and consumers using Health Information Exchanges (HIEs). As noted in the Summary of the Nationwide Health Information Network (NHIN) report from the Office of the National Coordinator, "An important core competency of the HIE is to maintain a trusting and supportive relationship with the organizations that provide data to, and retrieve data from, one another through the HIE. The trust requirement is met through a combination of legal agreements, advocacy, and technology for ensuring meaningful information interchange in a way that has appropriate protections."

NIST published "Security Architecture Design Process for Health Information Exchanges (HIEs) (NISTIR 7497)" in September 2010, to provide a systematic approach to designing a technical security architecture for the exchange of health information that leverages common government and commercial practices and that demonstrates how these practices can be applied to the development of HIEs. The publication assists organizations in ensuring that data protection is adequately addressed throughout the system development life cycle, and that these data protection mechanisms are applied when the organization develops technologies that enable the exchange of health information.

The operating model outlined in the publication will help organizations that are implementing HIEs to:

• Understand major regulations and business drivers.
• Identify cross-organizational enabling services.
• Define supporting business processes (for each service).
• Develop notional architectures (as a blueprint to support services, processes, and the selection of technical solutions).
• Select technical solutions.

Publications

• Security Architecture NISTIR 7497:  Security Architecture Design Process for Health Information Exchanges (HIEs) [The purpose of this publication is to provide a systematic approach to designing a technical security architecture for the exchange of health information that leverages common government and commercial practices and that demonstrates how these practices can be applied to the development of HIEs. This publication assists organizations in ensuring that data protection is adequately addressed throughout the system development life cycle, and that these data protection mechanisms are applied when the organization develops technologies that enable the exchange of health information.]