Here's an example of a model for HIE that just plain won't work. Not to mention it is ridiculously self-serving.

1. A New Patient-centric and Sustainable Path to Achieving Health Information Infrastructure William A. Yasnoff, MD, PhD, FACMI Managing Partner, NHII Advisors eHealthTrust™ February 19, 2006 © 2006 N H I I ADVISORS

2. I. What is the Current Vision for Health Information Infrastructure (HII) in Communities?

3. Clinical Encounter Index of where patients have records Temporary Aggregate Patient History Patient Authorized Inquiry Hospital Record Laboratory Results Specialist Record Patient data delivered to Physician Info Exchange Records Returned Requests for Records Community Clinician EHR System Encounter Data Stored in EHR Pointer to Encounter Data Added to Index

4. Index of where patients have records Temporary Aggregate Patient History Authorized Inquiry Hospital Record Laboratory Results Specialist Record Patient data delivered Info Exchange Records Returned Requests for Records U.S. Other Info Exchange

6. Operational Community HIIs Number of operational community HII systems using scattered model: NONE Not yet Central Indianapolis, IN YES Central South Bend, IN YES Central Spokane, WA Financially sustainable? Data Storage Name

8. II. A Path toward HII in Communities

9. Components of a Community Health Information Infrastructure Complete Electronic Patient Information Stakeholder cooperation Financial Sustainability Public Trust

27. eHealthTrust™ Clinical Encounter eHealthTrust™ Clinician EHR System Encounter Data Entered in EHR Encounter Data sent to eHealthTrust™ Patient Permission? NO DATA NOT SENT Clinician Inquiry Patient data delivered to Clinician YES $3 payment Clinician’s Bank Secure patient health data files

33. Questions? William A. Yasnoff, MD, PhD, FACMI [email_address] 703/527-5678 For more information: www.ehealthtrust.com www.yasnoff.com