What is health information exchange?
Health information exchange is the action of sharing relevant health information electronically among trusted clinical partners regardless of physical location. The information sharing can be about a single patient to enhance the care of that patient. Or, the information can be about a group of patients for the purposes of public health tracking and improvement.
Why is health information exchange important?
HIE can help with a broad array of care quality and provider workflow concerns, including referrals and discharges; lab and radiology orders and results; redundant testing; medication management; analytics and reporting to health agencies; chronic disease management; and paperwork. HIE can also help patient engagement and patient satisfaction. Ideally, HIE will ultimately reduce costs to health care system and to patients because of these care quality improvements. However, a 2015 review of studies on HIE impact, published in Health Affairs, found a lack of rigorous studies thus far on HIE’s affect on cost and quality.
Where are we at with health information exchange? How many providers can actually do it?
This is a tough one because there are so many degrees of ability to do HIE and use it once it is received on the other end. At its annual conference on May 31, 2016, the Office of the National Coordinator on Health IT (ONC) announced that 96 percent of U.S. hospitals now have EHRs certified to meaningful use standards. The agency said that 82 percent of nonfederal hospitals electronically exchanged laboratory results, radiology reports, clinical care summaries or medication lists with ambulatory care providers or hospitals outside their organization in 2015. That’s double the percent (41 percent) of hospitals doing HIE in 2008, according to the ONC’s data brief. However, the agency also reported that about one-third of those hospitals rarely or never use patient health information received electronically from outside their system for patient care, according to the data brief.
The federal meaningful use program incorporates HIE, requiring providers to engage in some HIE as part of Stage 2 certification. Stage 3 of meaningful use requires even more robust HIE capabilities. The ONC has a chart on criteria for the three MU stages.
What is a Health Information Exchange Organization?
A Health Information Exchange Organization (HIE/HIO) – sometimes known as a Regional Health Information Organization (or RHIO, pronounced “Rio“) – is an entity that provides health information exchange services to participating entities, usually clustered in one geographical region. HIEs/HIOs/RHIOs typically do all the legwork in terms of meeting capability, security and privacy standards for secure exchange of health information among participants. They often provide technical and advisory support services.
Ideas for journalists
Because there are so many variables on adoption and use of HIE, journalists should talk to a variety of hospitals, physician groups and other providers in their communities on their experiences with HIE. You may find that adoption and use varies wildly from one provider to the next in a single community. Pharmacists are another good source on HIE, as e-prescribing adoption picks up. Journalists can call local pharmacies and see how much they are actually using e-prescribing systems and how much they still rely on faxed orders.
Barriers and benefits to HIE can make a good local or regional story. Are there patients who have gotten help with medication management, or didn’t have to undergo a redundant radiology test because of HIE? Is HIE too cumbersome to fit into provider workflow at your local hospital, or are providers stymied from true exchange because of interoperability problems? Emergency departments are a good source because they typically see patients from outside their health systems.
Another idea is to check out what your local Health Information Exchange Organization is up to, if there is one. The following organizations have received federal funding for HIE/HIOs:
- Arkansas Office of Information Technology
- Colorado Department of Health Care Policy and Financing
- Delaware Health Information Network
- Illinois Health Information Exchange Authority
- Nebraska Department of Administrative Services
- New Hampshire Health Information Organization Corp.
- New Jersey Innovation Institute
- Oregon Health Authority
- Rhode Island Quality Institute
- South Carolina Health Information Partners
- California Emergency Medical Services Authority
- Utah Health Information Network
And the following organizations have received $1 million one-year federal grants for HIE/HIO services, according to the ONC:
- AltaMed Health Services Corp.
- Board of Regents of the University of Wisconsin Health System
- Community Health Center Network Inc. (San Leandro, Calif.)
- Georgia Health Information Network
- National Healthy Start Association
- Nevada Department of Health and Human Services
- Peninsula Community Health Services
- Rhode Island Quality Institute
- Utah Department of Health
- Washtenaw County, Mich., Community Support and Treatment Services
HIE coverage is an inroad for community members to better understand how their personal health information is being used – or not – to improve their care.
