Record Locator Service (RLS) — The Record Locator Service is the only new piece of infrastructure required by the Health Information Environment. The RLS is subject to privacy and security requirements, and is based on open standards set by the Standards and Policy Entity.
  • The RLS holds information authorized by the patient about where authorized information can be found, but not the actual information the records may contain. It thus enables a separation, for reasons of security, privacy, and the preservation of the autonomy of the participating entities, of the function of locating authorized records from the function of transferring them to authorized users.
  • Release of information from one entity to another is subject to authorization requirements between those parties; in certain sensitive treatment situations patients or providers may choose not to share information.
  • RLSs are operated by multi-stakeholder collaboratives at each sub-network and are built on the current use of Master Patient Indices.
  • The Record Locator Service needs to enable a care professional looking for a specific piece of information (PCP visit or ER record) to find it rapidly. An open design question is how and where in the model this capability can best be accomplished.

Solutions

A Record Locator Service (RLS) is a key infrastructure component to support interoperability in a decentralized healthcare environment. The RLS provides pointers to the location of patient information across the extended network, enabling users to access and integrate healthcare data from distributed sources without relying on National Patient Identifiers or centralized databases.
With user-defined relationships, organizations can use the RLS to correlate records of any type. For example, Patient-Physician relationships can be established by correlating Patient EMPI records with Provider EMPI records.
The combination of EMPI access, interface message tracking, and a flexible presentation layer supplies the necessary technical elements to develop a Record Locator Service. NextGate engineers have designed and implemented RLS processes to help achieve the vision of improved patient safety and quality of care.

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Architecture

HIEBus™ offers the services infrastructure for implementing secure record locator services (RLS), world class record-linking to enable a community master patient index, and a peer to peer data interchange platform that grows from small pilots to managing entire statewide populations. HIEBus™ is a comprehensive SOA technology platform for deploying health information exchanges that delivers

  • Federated architecture
  • Peer to peer data exchange
  • World class identity management
  • Comprehensive yet practical terminology services
  • Immutable audit and logging services
  • Service oriented architecture
  • Contemporary security standards
  • Granular data, patient, and provider based opt out capabilities
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  • Adapter
Each participating institution runs the CareEvolution Adapter Service that provides the interface between the Record Locator Service, peer institutions, and the institution's local clinical data sources (EMR/CDR, LIS, Pharmacy, Dictations)
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  • Record Locator Service (RLS)
The Record Locator Service (RLS) maintains an index of the locations of patient records for each person in the system. Clinical information is never sent to the RLS. Furthermore, the RLS only stores secured, blinded demographic information necessary for record linking. When a patient is registered with an institution, a query is submitted to the RLS. The RLS returns the location of any matching records. A location consists of a site identifier and a record identifier specific to the remote site.
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  • Peer to Peer Data Exchange (PtPE)
Finally, the located data interchange is managed purely between the adapters amongst institutions using encrypted web services.
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