Federated Electronic Health Records

Many State Government and Private agencies are developing programs for the sharing of Electronic Health Records (EHR) to improve patient care. By sharing information among health care providers, labs and insurance companies, a complete picture of an individuals prior test results and treatment history can result in quicker and more accurate diagnosis of an individuals condition.

The solutions deployed for EHR systems involve information sharing from many entities. Doctors offices, hospitals, laboratories, nursing homes, insurance companies and government agencies must collaborate to provide common data format, data definitions and presentation. As a result, these systems have resulted in two distinct architectures of which most implementations are some hybrid. The first architecture is a centralized model where data is collected in a centralized repository and made available through a centralized infrastructure. The second architecture is a federated model where each entity maintains their own data at their own location and provides access on an as needed basis.

Most EHR solutions provide some hybrid of the two purist models. In even the most centralized system some form of real-time data feeds exist to confirm the validity of the data being distributed or to provide the most up to date information. On the other hand, federated models still require a centralized record locator and/or other centralized data store.

In any of these models, the ability to interact with partners and vendors in a coordinated manner is critical. A key element to this coordination is a common security model to allow both external and internal users the ability to navigate systems in many locations and controlled by many agencies through a single authentication and authorization process.

A federated user provisioning tool integrated with a federated single sign-on system provides the ability for each organization to control access for their own employees and customers to the robust suite of federated and centralized electronic health information and systems.

For more information on EHR solutions and how federated security models can add value to the solution please contact Tirion Solutions Inc. Information on Tirion can be found at www.tirionsolutions.com .

Security Performance

Authentication and authorization can be major bottlenecks in system performance. The interaction of the resource with the security system can occur frequently and even seemingly fast response times add up to create overall performance degredation.

Unlike most applications that are server intense (such as a database driven application), security systems are network intensive applications. Firewalls, routers, circuits, encryption, decryption, digital signatures are involved in the overal security system response time.

A well designed security system will minimize the frequency of the interactions across the network, optimize the information being communicated and provide just the right information at just the right time to avoid interfering with the end applications performance.

What is MEUPS

MEUPS stands for Medicaid Enterprise User Provisioning System. This phrase was created during the development of the single sign-on and user provisioning system for the State of Kentucky medicaid system. Every doctor, nursing home and hospital that provides Medicaid services in the CommonWealth of Kentucky has an ID in MEUPS.

The system has been migrated and enhanced for the Florida Medicaid system where it manages the user ids for over 35,000 providers (doctors, hospitals, etc) and over 2,000,000 medicaid recipients.

The state of Georgia is also implementing MEUPS for their new medicaid system.

For more information contact Tirion Solutions at www.TirionSolutions.com.

Partner Relations

When companies partner on projects, they are faced with numerous political and technical challenges to information sharing. Even something as simple as a sharepoint site for the partners to access can become a daunting task. Simple questions like who should be allowed access, what priveledges can they have, what happens when someone quits, how is access terminated and other items are much more difficult in a partnering arrangement.

A federated provisioning system allows each partner to manage access for their own staff and eliminate the need for a central security administration team. For more information on federated user provisioning, see http://www.tirionsolutions.com/