Decision Support for Data Segmentation (DS2): Application to Pull Architectures for HIE

Architecture and protocol changes in the sharing of health records lead to a need for decision support functions that enforce privacy preferences of patients. These needs can be addressed with a collection of techniques called Decision Support for Data Segmentation (DS2).

Segmentation of patient medical records was once a side effect of paper media stored in separate locations. For instance, a patient might have a paper record at their primary provider and another record at a substance abuse treatment facility. There were two general types of sharing. In first case the paper record was in a place where it could be accessed by physicians at a provider facility, such as a hospital or clinic. This enabled sharing among the physicians at the provider. In a second case, when there was a need to share the records between two distinct providers (or other parties, such as the patient’s insurer), a representative of the originating provider would select relevant parts of the patient paper record and FAX them to the consuming provider. This act was usually done with patient consent and a knowledge of the goal for sharing the record, such as referral to a specialist or new primary care provider. For instance, a patient could decide if the consuming provider should receive substance abuse records from an originating provider.