For those unfamiliar with the term, health information exchange (HIE) refers to sharing clinical data in an electronic format across various health care organizations, according to national standards for encryption and security. The process is designed to eliminate boundaries in health care, allowing patient information to flow between hospitals, physician groups, long term care facilities, labs, and even government agencies like local health departments and the CDC. It is hoped that HIE will provide clinicians with quick access to test results and offer a consolidated view of a patient’s medical record, thereby improving patient outcomes and population health. (The entities that facilitate the sharing of electronic data are also known as health information exchanges or sometimes as health information organizations – HIOs.)
Despite the inconvenience of faxing or mailing paper records, the HIE movement is catching on slowly. InformationWeek recently reported on a study that found only 30 percent of hospitals and 10 percent of ambulatory practices belong to HIEs that transmit patient data across separate information systems. The most common type of data exchanged were lab results, discharge summaries, and clinical care summaries – very few providers are exchanging information with public health organizations at this point.
Yet within our increasingly tech-enabled society, digital communications only makes sense. Health care consumers, particularly the younger ones, are very tech-savvy. They are used to being able to access their banking data, for example, across locations and devices – and they wonder why this isn’t yet possible with health care, why they’re asked to provide their family history over and over again or to come into the office to receive lab test results. This is starting to change, as more health systems implement patient portals to facilitate communication between the patient and provider.
There are currently three key forms of health information exchange:
- Directed exchange is the ability for care providers to exchange patient information in order to support coordinated care. For example, a primary care physician might send an electronic summary of test results, medications, etc. to a specialist when referring a patient – and the specialist can then communicate the treatment plan and any recommendations for continued care. It can facilitate more seamless transitions of care while preventing duplication of services, medication errors, and the redundant collection of patient information.
- Query-based exchange refers to the ability for providers to search for and locate existing information on a patient. It’s useful in emergency room settings or for unplanned episodes of care, like a premature labor and deliver.
- Consumer-mediated exchange is the ability for patients to make their own health information available to providers – including reporting health data collected at home from glucometers and blood pressure devices, updating insurance information, and sharing test results with specialists.
Health information exchange is the next logical step, as more doctors and hospitals acquire electronic medical records. By 2014, physicians who are receiving incentive payments under the meaningful use program must have EMR systems that are Direct-enabled – that is, capable of securely sending and receiving clinical data between known and trusted parties, according to the technical standards outlined by The Direct Project.
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