HEALTH INFORMATION EXCHANGE

Health Information Exchange

Health Information Exchange

Introduction

Recently, health information organizations (HIOs) across the country have been developing networks to enable health information exchange (HIE) among diverse stakeholder within a given region. These stakeholders include clinicians, provider organizations, pharmacies, laboratories, radiology facilities, payers, emergency management and first responder groups, and health departments. Although there is some public health agency involvement in many HIOs, the primary use case of most HIOs - the way a system would be used by end users is centered on direct patient care with the primary goals of improving providers' access to information, thereby improving the safety and quality of care, and reducing costs. As part of this work, HIOs provide the organizational infrastructure, legal underpinnings, and technical expertise to enable HIE. This includes building physical data interfaces between the stakeholder and the HIO, and mapping proprietary database codes from each stakeholder to widely accepted standard vocabularies.

HIE History

Technology has been used to facilitate the flow of information between organizations in a wide variety of contexts. Many large scale-businesses use enterprise-wide systems to reduce costs and increase collaboration between previously isolated branches of their organizations. Effort to realize the potential gains from electronic health information sharing, often called Health Information Exchanges (HIEs), pursue the primary goal of facilitating the sharing of health information between physicians, hospitals, health plans, pharmacies, laboratories, and other relevant entities. The events of September 11, 2001 jumpstarted federal efforts to improve information sharing between isolated federal agencies to improve the nation's ability to react to potential threats to its security. The healthcare industry has attempted to facilitate the exchange of health information between segregated healthcare entities to capitalize on potential cost savings and increase quality of care for patients since 2003 (eHealth Initiative, 2010).

In the past decade, before 2000, public health has become increasingly attuned to the mounting burden of epidemics of chronic diseases and the growing efficacy of clinical preventive services (For example, lipid control, early detection of cancers) for asymptomatic individuals and medical treatment for prevention of sequelae for diseases such as diabetes and heart disease. Although the overall quality of preventive care is known to be poor, current methods of measuring the quality of care rely on chart reviews at provider settings or claims-based analysis of different insured populations (Beckjord, 2011).

In the days following the September 11th terrorist attacks in New York City, the Greater New York Hospital Association, a New York City-area trade association that represents hospitals and continuing care facilities, gathered and compiled emergency department visit logs from more than 100 hospitals and served as a single point of contact for these public requests. If a record locator service (RLS) architecture was designed to receive ongoing admission-discharge-transfer messages from clinical registration systems (with updated dates of service), then the HIO would be well-suited to fulfill this patient locator function (Kern, et al. 2011). In an example of local government support, the New York City Department of Health and Mental Hygiene led a CDC-funded Center of Excellence in Public Health ...