title: The lower saxony bank of health. rationale, principles, services, organization and architectural framework.
abstract: BACKGROUND
  This article is part of a Focus Theme of METHODS of Information in Medicine on Health Record Banking.
  
  
  BACKGROUND
  Poor communication of health care information between health care providers (HCP) is still a major problem. One recent approach is the concept of Health Record Banking.
  
  
  OBJECTIVE
  With this report we want to introduce the Lower Saxony Bank of Health (LSBH) to the international community. The main objective of this paper is to report and explain: 1) why this organization has been founded, 2) which basic principles have been set, 3) which services will be provided, 4) which type of organization has been chosen, and 5) which architectural framework has been selected.
  
  
  METHODS
  To report and discuss how we plan to achieve the intended objectives.
  
  
  RESULTS
  The LSBH was founded as an entrepreneurial company, regarding itself as a neutral third-party information broker. The bank does not store medical documents on its central servers but offers a document registry with links to documents stored at participating health care providers. Subject to valid patient consent, the LSBH grants access to these documents to authorized health care providers. To implement our services, we chose the established technical frameworks of the Integrating the Healthcare Enterprise (IHE) initiative using cross-enterprise document sharing (XDS).
  
  
  CONCLUSIONS
  Different approaches to establish health information exchange (HIE) are in early stages and some have failed in the past. Health Record Banking can address major challenges described in the literature about HIE. The future will show if our provider-sponsored business model is sustainable. After reaching a stable network, we intend to add additional HCPs, e.g., care homes or ambulance services, to the network.
authors.forename: M
authors.initials: M
authors.lastname: Plischke
authors.affiliation: Dr. Markus Wagner, Lower Saxony Bank of Health, Theodor-Heuss-Straße 2, 8122 Braunschweig, Germany, E-mail: markus.wagner@gd-bank.de.
authors.forename: M
authors.initials: M
authors.lastname: Wagner
authors.forename: B
authors.initials: B
authors.lastname: Haarbrandt
authors.forename: M
authors.initials: M
authors.lastname: Rochon
authors.forename: J
authors.initials: J
authors.lastname: Schwartze
authors.forename: E
authors.initials: E
authors.lastname: Tute
authors.forename: T
authors.initials: T
authors.lastname: Bartkiewicz
authors.forename: T
authors.initials: T
authors.lastname: Kleinschmidt
authors.forename: C
authors.initials: C
authors.lastname: Seidel
authors.forename: H
authors.initials: H
authors.lastname: Schüttig
authors.forename: R
authors.initials: R
authors.lastname: Haux
mesh_terms: D003199:Computer Systems; D019992:Databases as Topic; D057286:Electronic Health Records / Q000458:organization & administration*; D005858:Germany; D066275:Health Information Exchange; D006801:Humans; D008498:Medical Record Linkage; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D017146:Models, Organizational; D009937:Organizational Objectives
keywords: IHE XDS; eHealth; electronic health record; health information exchange; health record bank