Trust Framework for Health Information Exchange: A Framework for Governing Entities and their Participants to Share Trust Attributes to Support Exchange with a Group of Unaffiliated Entities. Nationa HIE Governance Forum.

摘要

One of ONCs governance goals for nationwide HIE is to increase trust among potential exchange participants to mobilize trusted exchange to support patient health and care. An essential aspect of trust for national HIE is an understanding of what an organization needs to know about another organization in order to exchange data. The National HIE Governance Forum Privacy and Security workgroup has developed this Trust Framework white paper to initiate a discussion of trust requirements between many stakeholders and ultimately lead to the construction of a concrete, real world solution. This is a preliminary step in what will likely be an extended collaborative effort. Although individual trust communities establish common requirements for their participants, the requirements and methods of verification necessary to be a member of that community are often not the totality of trust requirements that an individual organization follows when making a decision to exchange with unaffiliated organizations. The principle of local autonomy which allows for policy decisions about when to disclose what information, to whom, based on what evidence, is the role and responsibility of local policy makers i.e. Covered Entities and their patients and does not go away when an organization becomes a member of one or more trust communities. Trust communities simplify the process of determining who to exchange with but may not be sufficient in and of themselves to enable all forms of appropriate exchange. The unique considerations of every organization and the fact that the individual organization is accountable for the disclosures made by its authorized end users often creates the need to be able to discover additional trust attributes. The approach outlined in this white paper is of potential value to entities within a given trust community as well as entities in different trust communities whom are attempting to both disclose and learn of others trust attributes as part of their business practices.