HIM 540 Module 7 Final Project Milestone Three Example

Final Project Milestone Three: Sharing Data on Purpose, Interoperability and Data Sharing Agreements at Tidewater Crossing

[Student Name]

Southern New Hampshire University

HIM 540: Health Information Governance

Final Project Milestone Three

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Final Project Milestone Three: Sharing Data on Purpose, Interoperability and Data Sharing Agreements at Tidewater Crossing

Tidewater Crossing Health's clinicians cannot easily see records from the other half of their own system, because two hospitals run one record platform and two run another. Outside the system, exchange covers some neighbors but not others, and requests for data from researchers and partners are approved one at a time by whoever receives them. This milestone plans interoperability as a governed activity: which data move, by what standards, under which agreements and with whose approval.

Why Exchange Matters

Sharing is not an end in itself; it matters because of what it does for patients. Most of the exchange evaluations gathered by Menachemi et al. (2018) reported benefits, such as reduced duplicate testing and imaging and lower emergency department costs. Yet capability often lags. Holmgren and Adler-Milstein (2017) reported that full engagement in all four exchange activities remained uncommon among US hospitals, and that bringing outside information into clinicians' workflow lagged the rest. And willingness has not always matched capability: Adler-Milstein and Pfeifer (2017) found that exchange leaders believed information blocking by vendors and health systems was common before federal rules made it a violation. Tidewater Crossing's plan addresses capability, workflow and willingness together.

Bridging Two Platforms

Moving all four hospitals to one record platform is the long-term goal, but it will take years. In the meantime, the system will connect the two platforms through standard interfaces so that a clinician at any hospital can view a patient's problems, medications, allergies, results and recent notes from the other platform within the chart. Both platforms support HL7 FHIR interfaces and exchange of the federal core data set, and the enterprise patient identifier from Milestone Two will link records. The data governance committee will define which data classes are shared first, starting with those that matter most for safe transfers.

External Exchange

Externally, the system will pursue four flows. National exchange: joining a qualified network under the national trusted exchange framework lets the system query records from participating providers anywhere, not only local partners. Patient access: both platforms offer standard application programming interfaces, and the system will publish plain-language guidance so patients can connect apps of their choice. The implementation literature surveyed by Ayaz et al. (2021) shows FHIR spreading through patient access and clinical tools while inconsistency and security remain open problems, which the system will address by testing interfaces before promoting them. Public health: electronic case reporting and immunization reporting will run from both platforms to the state health department. Payers: as federal rules require payers to support standard interfaces for data exchange and prior authorization, the system will connect for those purposes as well.

Making Outside Data Usable

Access is only half of interoperability; the other half is making outside data usable. Clinicians at Tidewater Crossing already ignore some outside documents because they arrive as long files that are hard to scan. The plan therefore focuses on reconciliation: outside medications, allergies and problems will appear in a reconciliation view at admission, where a nurse or pharmacist can accept them into the chart as structured data with their source recorded. Results from outside laboratories that carry standard codes will file into the patient's results view beside local results. Health information staff will monitor how often outside data are accepted and report to the data governance committee, since low acceptance usually signals a workflow or data quality problem rather than a lack of connections.

Matching Flows to Agreements

Every data flow needs a governing agreement, and the type depends on the relationship. Table 1 matches each flow to its agreement.

Table 1. Data Flows and Governing Agreements

Note. Prepared by the author with counsel and the privacy officer.

An Approval Path for New Sharing

Requests to share data will no longer be approved by whoever receives them. Every new external data sharing arrangement, other than patient access and required public health reporting, will be submitted through a single intake form describing the recipient, purpose, data elements, identifiability and security. The privacy officer reviews it with counsel and information security, the data owner confirms the data can support the purpose and the information governance council approves arrangements involving identifiable data or new types of partners. Approved arrangements are recorded in a sharing register with renewal dates, so the system always knows where its data go.

Sensitive Data

Some data require special handling when shared. Records from the system's addiction treatment program fall under federal confidentiality rules that require patient consent, though revised federal rules let one signed consent reach later sharing for care, payment and operations; they must be tagged so that exchange can respect those rules. Adolescent confidential services, behavioral health notes and genetic results also need attention under state law and policy. The data governance committee will maintain a list of sensitive data classes, and interfaces will segment them according to that list before any new exchange goes live.

Measures

Progress will be measured by the share of transfer patients with outside records available at arrival, the share of cross-platform lookups completed within the chart, the number of data sharing arrangements in the register with current agreements, time to approve new requests and incidents involving shared data. Targets for the first year are outside records for 80% of transfers and every external arrangement documented in the register.

Conclusion

Interoperability at Tidewater Crossing will mean sharing data on purpose: bridging its own two platforms, joining national exchange, supporting patient access and required reporting, matching every flow to the right agreement and approving new sharing through one governed path. In the final project, this plan joins the governance structure, the collection plan and the life cycle policies as parts of a single program.

References

Adler-Milstein, J., & Pfeifer, E. (2017). Information blocking: Is it occurring and what policy strategies can address it? Milbank Quarterly, 95(1), 117-135. https://doi.org/10.1111/1468-0009.12247

Ayaz, M., Pasha, M. F., Alzahrani, M. Y., Budiarto, R., & Stiawan, D. (2021). The Fast Health Interoperability Resources (FHIR) standard: Systematic literature review of implementations, applications, challenges and opportunities. JMIR Medical Informatics, 9(7), Article e21929. https://doi.org/10.2196/21929

Holmgren, A. J., & Adler-Milstein, J. (2017). Health information exchange in US hospitals: The current landscape and a path to improved information sharing. Journal of Hospital Medicine, 12(3), 193-198. https://doi.org/10.12788/jhm.2704

Menachemi, N., Rahurkar, S., Harle, C. A., & Vest, J. R. (2018). The benefits of health information exchange: An updated systematic review. Journal of the American Medical Informatics Association, 25(9), 1259-1265. https://doi.org/10.1093/jamia/ocy035