The next step in health data exchanges: trust and privacy in exchange networks.

The rapid development of health information exchanges (HIE), regional health information organizations (RHIO), the Nationwide Health Information Network (NHIN) and other data exchange platforms for health records creates complex and multifaceted challenges for protecting the privacy and security of health information. Often these issues are addressed in a contractual agreement between two parties seeking to exchange data. Until recently, this point-to-point approach has been acceptable because there were few operational HIEs or RHIOs that were ready, willing and able to actually exchange data. With the proliferation of HIEs and RHIOs that are either operational or on the cusp of being operational, the utility of point-to-point is diminishing. It is no longer efficient for a RHIO to negotiate a separate data exchange agreement with every one of its exchange partners. The evolving model for data exchange agreements is a multi-party trust agreement. This article will examine the crucial components of a multi-party trust agreement.