Architectures and approaches to manage the evolving health information infrastructure

The objective of a large-scale health information infrastructure is to unify the health data collected and maintained by many disparate individual organizations that may use unique and incompatible terminology. Efficiently exchanging health information between these heterogeneous systems requires an infrastructure that meets some key technical requirements. This chapter describes the various high-level architectures that health information organizations have implemented to facilitate data exchange. It further discusses the processes used to transfer data between multiple systems within a health information exchange network and outlines common transaction types. The requisites for achieving interoperability between heterogeneous information systems are also discussed. An internal component of a model health information infrastructure that has been leveraged to simplify interoperability between discordant systems called the interoperability layer is examined in detail. The chapter finally discusses several emerging trends influencing the evolution of health information infrastructures.