Many local and state health departments have led HIE development in their own communities. For example:
- Public health leadership has often been critical to facilitating collaboration among competing healthcare providers.
- The immunization registry was an early, single-function model of HIE.
- Some health departments participated in HIE development to promote near-real-time case reporting of reportable diseases. Some also used HIE to monitor surges in healthcare utilization to detect or track outbreaks - this is now referred to as syndromic surveillance.
- Others have used information exchange to establish disease registries and improve chronic disease management.
Now that federal programs are incentivizing exchange and establishing national specifications, health departments may be less prominent in driving exchange, but may see more benefits faster.
Communities are beginning to use HIE to support more profound health system transformation, for instance:
- to support better care coordination and access;
- to measure, analyze and improve the delivery of clinical preventive services for individuals, or for entire populations
- to aggregate HIE data to map and attack health inequities
HIE is not a destination - it is a foundation.
HIE is both catalyst and mechanism for ongoing improvement in public health surveillance, healthcare and preventive services. Not every health department needs to implement HIE today. Some local health departments, for instance, may find it more appropriate to rely on state-operated information systems to exchange information with healthcare providers.
The next section of this toolkit, Do We Need HIE Today?, offers tools to assist public health departments in determining when to make HIE a priority.
Nevertheless, every health department will be affected as HIE changes the characteristics, speed and volume of data exchange activities with healthcare providers. It is critical to be prepared to use this information for the benefit of the public's health.