The following Frequently Asked Questions (FAQ) and answers provide high-level information on the concept and implementation of health information exchange (HIE).
Health Information Exchanges provide the capability to electronically move clinical information among disparate healthcare information systems and maintain the meaning of the information being exchanged. (HIMSS Dictionary of Healthcare Information Technology Terms, Acronyms and Organizations, Third Edition)
There are several different types of health information exchange and health information exchange organization currently operating across the United States and its territories:
A Health Information Exchange Organization (HIO) is an organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards. The purpose of a health information exchange organization is to perform oversight and governance functions for HIEs.
Health information exchanges and health information exchange organizations can provide many important benefits for providers, patients and hospitals, such as:
There are three primary types of HIE architecture used across the United States:
Depending on the services needed, some providers may need to connect to multiple HIEs, as some HIE solutions may provide only basic services. One must conduct due diligence with the available HIE service providers to determine their service offerings and how they support the organization's needs.
The Health Information Exchange Importance Checklist and the guidance on Approaching Health Information Exchange Engagement provided in the HIMSS/NACCHO HIE Toolkit for Public Health can be a good starting point for any organizations, not just public health departments, to explore available HIE solutions. The resources provided in the HIMSS Ambulatory HIE Toolkit's Evaluating Health Information Exchange/Health Information Exchange Organization Opportunities section offer additional guidance.
Health information exchanges/health information exchange organizations provide the capability to electronically move clinical, business and financial information among disparate healthcare information systems while maintaining the meaning of the information being exchanged.
The primary types of data exchange utilizing services provided by an HIE include:
An Electronic Health Record (EHR) is a longitudinal health record of patient health information generated by one or more encounters in any care delivery setting. The EHR automates and streamlines the clinical workflow.
Health information exchanges and HIOs offer many benefits that EHRs, in general, do not, such as:
DIRECT is a secure email messaging service leveraging secure, encrypted and HIPAA-compliant services.
The eHealth Exchange (formermly referred to as the Nationwide Health Information Network, or NwHIN) is a group of federal agencies and non-federal organizations that came together under a common mission and purpose to improve patient care, streamline disability benefits claims, and improve public health reporting through secure, trusted and interoperable health information exchange.
Additional information on Healtheway and the eHealth Exchange was presented on HIMSS' Spring 2014 HIE Community Roundtable.
A Health Information Service Provider (HISP) is an organization that supports the secure transport of health information, including both structured and unstructured data.
There are several consent models used by HIEs/HIOs, each with its own advantages and disadvantages.
The U.S. Department of Health and Human Services' HIPAA requires HIEs/HIOs to have privacy and security policies and procedures in place to safeguard health information when it is exchange. Privacy and security considerations may include the following:
The Centers for Medicare & Medicaid Services (CMS) provide tools called Clinical Quality Measures (CQM) that help providers to measure and track the quality of healthcare services provided.
Sample workflows can help to better understand how to utilize HIE/HIO services. The following examples (both patient-specific and non-patient-specific) can be facilitated by HIE service providers.
HIE services can be used in several ways to support Meaningful Use (MU) transitions of care measures, such as in the following examples: