The Secure, Fast Way Healthcare Providers Exchange Info

Opening channels of communication to improve patient care

Health Information Exchange
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Health information exchange (HIE) is the secure electronic exchange of health information among otherwise disconnected healthcare organizations. The goal of HIE is to allow clinicians and patients to access critical health information, at the right time in the right place, in order to provide or facilitate the best possible care. An HIE is formed when a network of organizations follow recognized standards to share electronic health information. Hospitals, clinics, pharmacies, and lab facilities can be connected by HIE at the regional, state, or national level.

Without HIE, information is locked in each organization’s electronic health record (EHR) or other information systems, which makes it difficult for clinicians to access data pertaining to patients who have received healthcare from multiple organizations. HIE allows healthcare providers in separate organizations to view and share a patient’s health information (e.g. vital signs, test results, medications) at the point of care. Patients can also use HIE to manage the flow of their health information.

When is HIE useful?

There are several scenarios where access to clinical data would be useful for heath care providers and patients:

  • Patient is transferred from one hospital to another
  • Patient is sent to the emergency department after having tests done in a clinic
  • Patient is discharged from a hospital and then follows up in a clinic
  • Patient moves across town and finds a new primary care provider

In all of these transitions of care, the patient would have health information stored in the EHRs of the first facility which would impact the type of care delivered at the second facility, if only the providers had access to it. HIE makes this possible.

Benefits of HIE

Timely sharing of data can help clinicians and patients make better decisions at the point of care. Specific benefits of HIE include:

  • Avoid unnecessary readmissions
  • Avoid duplicate testing. If clinicians can see the results of recent tests, they would not need to order the tests again
  • Higher quality care.

For example, a study by James Bailey and colleagues demonstrated that when healthcare providers in emergency departments used HIE to access records for patients with headache, they were less likely to order costly imaging studies (e.g. CT scans) and were more likely to follow evidence-based guidelines for management of headache.

Types of HIE

There are three main forms of HIE:

  • Directed Exchange allows healthcare providers who know and trust each other to send and receive information about a patient. Providers also use this type of exchange to report quality measures or immunization data.
  • Query-based Exchange allows providers to find and/or request information about a patient from other sources.
  • Consumer Mediated Exchange allows patients to access and manage their own health information. They can share the information with their healthcare providers.

Patient consent for HIE

HIEs have different arrangements for allowing patients to control if and how their information is made available for sharing between healthcare organizations:

  • Opt in: The default is that patient health information is not shared. Patients must actively express their wish to share either all of their information or only a part of it
  • Opt out: The default is that patient health information is available for sharing. If they wish to prevent sharing all or part of their information, patients must actively express this wish
  • No consent: Health information is available for sharing, and patients cannot opt out.

The extent to which HIE achieves interoperability will influence the perceived value among clinicians and patients. Fully interoperable HIE has the potential to improve the safety, quality, efficiency, and cost of health care. Building regional, state, and national HIE requires considerable resources as well as the collaboration of multiple stakeholders. 

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