Health information exchange
Health information exchange (HIE) is the mobilization of healthcare information electronically across organizations within a region, community or hospital system.
HIE provides the capability to electronically move clinical information among disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer and more timely, efficient, effective, and equitable patient-centered care. HIE is also useful to public health authorities to assist in analyses of the health of the population.
HIE systems facilitate the efforts of physicians and clinicians to meet high standards of patient care through electronic participation in a patient's continuity of care with multiple providers. Secondary health care provider benefits include reduced expenses associated with:
- the manual printing, scanning and faxing of documents, including paper and ink costs, as well as the maintenance of associated office machinery
- the physical mailing of patient charts and records, and phone communication to verify delivery of traditional communications, referrals, and test results
- the time and effort involved in recovering missing patient information, including any duplicate tests required to recover such information
According to an internal study at Sushoo Health Information Exchange, the current method of exchanging patients' health information accounts for approximately $17,160 of expenses annually for a single-clinician practice.
Formal organizations are now emerging to provide both form and function for health information exchange efforts, both on independent and governmental/regional levels. These organizations are, in many cases, enabled and supported financially by statewide health information exchange grants from the Office of the National Coordinator for Health Information Technology. These grants were legislated into the HITECH components of the American Reinvestment and Recovery Act in 2009. The latter organizations (often called Regional Health Information Organizations, or RHIOs) are ordinarily geographically defined entities which develop and manage a set of contractual conventions and terms, arrange for the means of electronic exchange of information, and develop and maintain HIE standards.
In the United States, federal and state regulations regarding HIEs and HIT (health information technology) are still being defined. Federal regulations such as "Meaningful Use" legislation as well as the implementation of some state governments of state-sponsored HIEs (such as the North Carolina HIE) in addition to fluctuating health care regulations among the states are rapidly changing the face of this relatively new industry. HIEs and RHIOs continue to struggle to achieve self-sustainability and the vast majority remain tied to Federal, State, or Independent grant funding in order to remain operational; with some exceptions such as the Indiana HIE.
Established HIE communities
- Chesapeake Regional Information System for our Patients
- CRISP is a non-profit corporation that is implementing health information exchange in the state of Maryland. The organization also serves as the Health IT Extension Center for Maryland. CRISP was created by Johns Hopkins Medicine, MedStar Health, the University of Maryland Medical System and Erickson Retirement Communities. Audacious Inquiry serves as program director and technical architect for the health information exchange while Dynamed Solutions provides project management and organizational support under CRISP.
- Colorado Regional Health Information Organization (CORHIO)
- CORHIO is Colorado’s state designated entity for health information exchange. As of April 2013, about 28 Colorado hospitals and more than 700 doctors were connected to the CORHIO HIE.
- Delaware Health Information Network ()
- DHIN is a non-profit public-private partnership enacted by the Delaware General Assembly in 1997, for the benefit of all citizens of Delaware to advance the creation of a statewide health information network and to address Delaware's needs for timely, reliable and relevant health care information. DHIN has adopted regulations to govern its operations and has policies and procedures in place to support privacy and security of patient information. DHIN enhances a health care information exchange started in May 2007. In February 2012, The Delaware Health Information Network announced full participation of all acute care hospitals and skilled nursing facilities in the state, along with the vast majority of Delaware providers, in the first statewide community health record. As of June 2013, DHIN has attracted the participation of 97 percent of Delaware providers, tracks nearly 88 percent of Delaware's population, and delivers more than 10 million clinical results and reports to participating providers annually. 
- Frysian Health Information Exchange ()
- The Friesland Regional Cardiology Network speeds up the referral process, improves both diagnosis and the clinical decision process, and on average reduces by one or two days the length-of-stay for patients in hospitals. From their office workstations, cardiologists are able to consult the advanced clinical images provided by any hospital linked to the network. The distributed storage of records eliminates the duplication of records across multiple sites. Once uploaded to the cardiology network, records remain available for consultation at any time so that previous episodes of a patient’s care can be consulted in detail no matter where the care was provided in the region.
- Harvard Pilgrim Health Care
- HPHC is a non-profit insurance provider which serves members throughout Massachusetts, New Hampshire, and Maine. The provider offers variety health insurance options for companies, families and individuals. Customers health insurance expectations are met through a tailored options from preferred provider organization (PPO), point-of-sale (POS), and health maintenance organization (HMO). HPHC implements CRM, Master Data Management and is now implementing Oracle Policy Automation to support integrated call center and online self-service for plan purchase and management across their various customer groups additionally, HPHC is using their platform to support recruitment and to better analyze and improve service levels in a heavily competitive market.
- Indiana Health Information Exchange ()
- The Indiana Health Information Exchange operates the U.S.'s largest HIE and one of the oldest with data on more than 7 million patients, connecting hospitals, rehabilitation centers, long term care facilities, laboratories, imaging centers, clinics, community health centers and other healthcare organizations. Created and ran by the Regenstrief Institute, a medical informatics think tank, the Indiana Network for Patient Care (INPC), a secure network provides a patient records to participating doctors. This HIE grew over time from 12 hospitals in the center of the state with approximately 5,000 physicians, to 93 hospitals out of 114 in the state and more than 14,000 physicians in Indiana.
- Utah Health Information Network ()
- The Utah Health Information Network (UHIN) is a broad-based coalition of Utah healthcare insurers, providers, and other interested parties, including the Utah State government. Since 1993, UHIN members have come together for the common goal of reducing healthcare costs and improving the quality of care through the use of electronic data interchange (EDI) for healthcare transactions. Exchanging information electronically rather than by phone, fax or surface mail means that data can get to those who need it securely, economically and efficiently. UHIN currently serves nearly all the hospitals, ambulatory surgery centers, national laboratories, insurers, and approximately 90% of the medical providers in Utah as well as the Utah State government. As a community organization the focus is on creating data exchange solutions that work for the entire healthcare community, from large integrated networks to single-provider offices. The Clinical Health Information Exchange (cHIE) is a secure electronic way for medical professionals to share and view patient information that is needed at the point of care. The cHIE makes this information accessible, with patient consent, to authorized users while maintaining the highest standards of patient privacy.
- DICOM (Digital Imaging and Communications in Medicine)
- LOINC (Logical Observation Identifiers Names and Codes)
- Health informatics
- Health Level 7 (HL7)
- Integrating the Healthcare Enterprise (IHE)
- Medical imaging
- Regional Health Information Organization (RHIO)
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