The response to the COVID-19 pandemic has shown the even greater importance of ensuring the right information is accessible to those who need it. Health information exchange (HIE) organizations play an essential role in aggregating and disseminating data to give local hospitals, public health officials and providers a better understanding of the virus’ spread and the patients being tested and treated. Several national exchange efforts are contributing to the response, but as the U.S. deals with a pandemic that impacts each region differently, these regional HIE organizations play a vital role and can have a direct impact on a community’s preparedness and response to COVID-19.
Historically, HIE organizations have successfully responded to all kinds of crises — both natural and man-made disasters. During recent hurricanes, wildfires and mass shootings, these entities have played critical roles and are viewed as a reliable source of truth when exchanging information for the many people displaced from their normal care settings.
As the United States braces for the apex of the COVID-19 pandemic, HIEs play the extremely important role of exchanging data, facilitating the ability for frontline staff to save lives every day, everywhere. The following are real-world examples of how HIEs have prioritized in their response efforts:
Even with the incredibly positive role these entities play in connecting essential data points, there are persistent organizational and technical barriers that impede even more robust exchange. These problems aren’t new and are deeply embedded within our healthcare ecosystem, and unfortunately, COVID-19 has merely exposed them even further.
Gaps in the Data Exchange Ecosystem: To date, many regional HIEs have expressed challenges connecting with one of their key stakeholders — the labs processing the COVID-19 test results — to ensure robust virus surveillance and coordination. Further compounding the issue, some HIEs may not have formally established connections with state and local public health departments, so meaningful gaps remain between hospitals and public health entities in terms of the information that should be communicated on an ongoing basis.
Evolving Technical Needs: Organizations have been quick to release new CPT and ICD-10 codes to document COVID-19 cases. However, many healthcare organizations don’t have the technical infrastructure to handle basic exchange needs. As mentioned above, HIE Networks in Florida is allowing new data sources, such as faxes, to be exchanged, but challenges remain around the integration of that data into broader information for the community.
The current pandemic has created an extraordinarily dynamic landscape in which policymakers are furiously working to keep up with the evolving needs of our healthcare ecosystem. New state and federal guidance, directives and mandates are being released at an accelerated pace to decrease barriers and encourage faster, more impactful exchange.
For example, in California, state entities are now authorized to share relevant medical conditions, as necessary, to mitigate the COVID-19 outbreak with governmental and nongovernmental partners for the limited purposes of monitoring, investigation and control and treatment and coordination of care.
To mitigate issues with data sharing from labs, some states and jurisdictions are imposing new requirements around the release and access to COVID-19 lab results. For example, Riverside County in Southern California now requires labs now report data through Manifest MedEx, their regional HIE, for exchange and access with departments and facilities in the area.
At the federal level, HHS’s Office of Civil Rights (OCR) announced a number of flexibilities and guidance on what protected health information (PHI) can be shared as it relates to COVID-19. These flexibilities expand the offerings of data that HIEs can make available to their participants. For example, OCR has released HIPAA guidance on when COVID-19-related PHI can be disclosed to law enforcement, first responders and public health employees. They have also relaxed HIPAA noncompliance penalties on business associates sharing PHI with public health authorities in good faith, even if such disclosures are not permitted in their existing business associate agreement. As HIE organizations are and/or work with business associates, this notice can have positive implications on COVID-19 data exchange.
HIMSS encourages states, HIE organizations and partners to consider the following:
Healthbox, a HIMSS solution, launched the COVID-19 Digital Think Tank, a valuable resource for you as you lead your facility, team and patients through the crisis. Share what you know, see what’s working for others, and bring lessons back to your community. Engage with the HIT community on solutions.
The Interoperability & HIE Community Spring Roundtable will highlight two HIEs in their efforts to improve outcomes in the face of the COVID-19 pandemic. Join us on April 29.
Get the latest news and resources to stay on top of the COVID-19 pandemic.