1. Patient Safety Institute

2. For Communities to Share Data, you need Partnerships
Hospitals
Labs
Payor
Patients

3. What’s Required?
TRUST: need for a trusted National Medical Information Exchange (NMIE) that provides real time access to critical patient information (with patient consent) at the point of care.
Who needs to be involved? physicians, hospitals, patients and support of consumer advocates. Someone has to provide an over arching, representative structure to facilitate an NMIE.
Need structure for NMIE that complements existing national, state and local information sharing capabilities.
Patient Safety Institute Is
the healthcare industry's response to the need for a trusted, National Medical Information Exchange (NMIE) that provides real time access to critical patient information (with patient consent) at the point of care .  The PSI NMIE operates similar to the way that VISA® does. Both provide a representative governance structure and a communications network that provides real time access to data which resides in disparate information stores. PSI focuses on providing access to information banks of existing medical information to healthcare providers (with patient consent) at the point of treatment.
a non-profit organization governed by leading physician, hospital and consumer advocates. PSI was created solely to provide an over-arching, representative, structure to facilitate a NMIE. In addition to creating a comprehensive governance and organizational structure that supports local community efforts, PSI provides a communications infrastructure that can support inter-community connectivity and missing intra-community connectivity as well as single source access to national data sources (e.g. laboratory results, medication history, diagnoses and immunizations). 
a structure for NMIE that complements existing national, state and local information sharing capabilities. PSI is not a vendor of services which requires wholesale change to a participant’s technology strategy; but rather a collaborative organization which simply facilitates NMIE in a way that removes many of the existing barriers, including patient privacy concerns, inter-community competitive pressures and the need for significant infrastructure investments by participants.

4. Requirements for National Medical Information Exchange
"Trusted" cross-industry representative governance
Better if Non-profit
Core mission of patient privacy, security and choice
Open, non-proprietary, scalable infrastructure architecture
National design while community driven
Connectivity to national data sources
Single membership model rather than peer to peer contract model
Single focus on healthcare network access for all (like VISA® for financial information)
State-wide collaboration and direction 

5. Sample National/State Community Approach
Meds & Allergies
PBMs &
Pharmacies
State Z
Model
National Diagnosis
Meds, Immunizations
& Enrollment
Regional
Hub*
Insurers
National
Labs
Lab
Co’s
National Patient
Verification
& Supplemental
Data
Patient
Portals
State Y
Model
Claims Data & Enrollment
Medicare &
Employers
Immunizations & Other State Registries
Medicaid, SCHIP
State-Funded Indigent Care
Head Start
WIC
Community Health Centers
Workers’ Compensation
EMS
Correction Facilities
Food Stamps
Etc.
State X
Model
State
Programs
Physician Data
Integrators
Physician Portals,
ASPs and large clinics*
State Public Policy
& Academic Research*
Hospitals
& Other
Providers
Individual
Physicians
Via State Designee
(State Medical Society or
Licensing Board)*
Basic Safety Data*
* w/Patient Permission

6. How PSI Works – Technical Overview
Physician
Patient
Hosp./Clinic A 1 3
The PSI Hub sends a
request/response message
to retrieve the critical patient information 2
PSI
Switch
Physician requests
information using a PDA
or Browser. The request
is transmitted to the PSI Hub 1 3 2
Community
Labs
Hosp./Clinic B
PSI
Hub
PSI
Switch
PSI
Switch
The PSI Hub gathers and
formats the critical patient information.
This information is then transmitted to
the requestor, formatted to
the appropriate device footprint 3
PSI
Switch
Community
Pharmacies
Pharmacist
Patient

7. Research, Treatment & Clinical Trial Information
PSI – Patient Connectivity
Patient
Caregiver
Review
Append
Contribute
Communicate
Patient Portal
(of patient’s choice)
Research, Treatment & Clinical Trial Information
Physicians
Services
Community
Labs
PSI
Hub
Hosp./Clinic
Physician
Patient
Pharmacist
Patient
Community
Pharmacies