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Outcomes from the Privacy and Security Solutions for Interoperable Health Information Exchange Project

Human profile with super-imposed padlock, representing privacy and security of protected health information.
Below are the final reports produced under RTI International's contract with the Agency for Healthcare Research and Quality (AHRQ). The contract, entitled Privacy and Security Solutions for Interoperable Health Information Exchange, was managed by AHRQ and the Office of the National Coordinator for Health Information Technology (ONC). The reports provide a summary and an analysis of work performed by 33 States and one territory as subcontractors to RTI; these subcontractors form the Health Information Security and Privacy Collaboration (HISPC).

The purpose of the Privacy and Security Solutions for Interoperable Health Information Exchange project was to assess variations in organization-level business practices, policies, and State laws that affect electronic health information exchange and to identify and propose practical ways to reduce the variation to those "good" practices that will permit interoperability while preserving the necessary privacy and security requirements set by the local community.

State teams engaged a broad array of stakeholders within their State to:

  1. Review organization-level business practices to assess the variation and identify good practices as well as those that will require modification to be applied sensibly to eHIE.
  2. Develop consensus-based solutions to reduce variation and other barriers to interoperability.
  3. Develop detailed plans for implementing solutions.

Assessment of Variation and Analysis of Solutions

The Assessment of Variation and Analysis of Solutions (AVAS) summarizes and analyzes reports submitted by the 34 subcontracted State teams and represents a "final look" at the major areas States have identified as presenting challenges to achieving interoperable electronic health information exchange. This summary report captures the highlights from the 34 reports and presents some of the major crosscutting themes that have been raised during the State teams' discussions.

  • AVAS Report (PDF, 677 KB, Text) (Persons using assistive technology may not be able to fully access information in this report. For assistance, please contact Corey Mackison).
  • AVAS Executive Summary (PDF, 102 KB) (Persons using assistive technology may not be able to fully access information in this report. For assistance, please contact Corey Mackison).
  • AVAS Appendices (PDF, 480 KB) (Persons using assistive technology may not be able to fully access information in this report. For assistance, please contact Corey Mackison).

Individual HISPC Reports

In addition to the AVAS, many of the HISPC teams have made their final reports available online. These reports can be found on the individual team Web sites, which can be accessed via the HISPC main page on the AHRQ Health IT Web site.

Summary of State Teams' Implementation Plans

Also available is a summary of the State project teams' final implementation plans (FIP), documents that will guide the development and adoption of a framework for privacy and security for electronic health information exchange in each State or territory. The summary offers cross-project themes and plan elements that may be useful to others seeking methods to bring stakeholders together to address the need for privacy and security when exchanging electronic health information.

  • Download the FIP Report (PDF, 102 KB, Text) .
  • Download the FIP Executive Summary (PDF, 102 KB) .

Nationwide Summary

This report provides a comprehensive review of the work conducted by the subcontractors throughout the course of the project. Although theprimary sources of information described in the Nationwide Summary report are necessarily State-specific, the report affords the opportunity to look across the activities conducted by the 34 State teams and to better understand what policies and practices need to be in place within and across States to both protect health information and promote nationwide electronic health information exchange. The report is an effort to expand the ideas and plans the subcontractors developed by identifying common challenges and areas for ongoing collaboration.

The report also incorporates issues raised during discussions at the regional and national meetings and presents discussions of key issues, based on the expertise of the members of RTI's Technical Advisory Panel (TAP) regarding the often complex interactions between State and federal law. This report further addresses the broader implications of the project, makes recommendations for federal action that can facilitate nationwide electronic health information exchange, and may serve as a roadmap for State and federal agencies establishing privacy and security policies governing nationwide electronic health information exchange.

  • Download the Nationwide Summary Report (PDF, 829 KB, Text) (Persons using assistive technology may not be able to fully access information in this report. For assistance, please contact Corey Mackison).
  • Download the Nationwide Summary Appendices (PDF, 288 KB) (Persons using assistive technology may not be able to fully access information in this report. For assistance, please contact Corey Mackison).

The Health Information Security and Privacy Collaboration Toolkit

The toolkit provides guidance for conducting organization-level assessments of business practices, policies, and State laws that govern the privacy and security of health information exchange (HIE). The toolkit serves as an appendix to the AVAS with the intention of providing tools that others can use locally or Statewide.