Understanding Health Information Exchange

I recently attended a break out session at the Centricity Healthcare User Group (CHUG) Fall meeting in Washington D.C. on health information exchange (HIE) in Oregon.  HIE is an information system that allows individual health care providers to exchange data with trusted partners about patients shared among the partners.  For example, clinical data about a patient in Oregon that goes to a local hospital and a specialty physician (like a cardiologist) can be shared via an HIE.

Health IT compatibility with an HIE is also a American Recovery and Reinvestment Act (ARRA) requirement for providers to receive incentive payments from Medicare or Medicaid under the Act.  That means that a physician practice that buys an information system will need to contemplate how that system could interact with an HIE to be eligible to receive the $44,000 to $64,000 in investment money available through the ARRA starting in 2011.

HIE is an obvious step forward with health technology.  Health IT started out as a localized solution to manual or paper processes in the offices of individual providers back in the bad old days of computing.  That meant that the data collected was stored locally and was unavailable to other systems or individuals who might find it useful.  For example, if you go to the doctor’s office, the office “registers” you to their system (paper or electronic), which means that you provide specific demographic information to the registrar.  In the bad old days, you’d do this repeatedly every time you went to another physician or ancillary service (like the lab, radiology, etc.).

HIE presents a way for trading partners to be able to share this data, which helps to reduce the amount of time spent filling out forms for patients, and also reducing the administrative time required by each medical facility in keeping track of your address and insurance information.  And, it should also increase the overall accuracy of the data stored across systems.

HIE also is aimed at clinical information.  If you have a primary care and a specialist physician, both ought to know what medications you are taking, regardless of who the prescriber was.  HIE provides a way to share this information automatically.  The folks in Oregon have also implemented their HIE to support sharing problems and allergies, and it sounds like they are planning to implement methods to share other kinds of data in the future.

Maryland is in the process of developing its own HIE (see this press release from DHMH); HIE was a legislative priority to the Maryland General Assembly this year, which did result in a law mandating HIE in some fashion over the next several years.  (See blog post on this topic here)  More to come!

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Maryland technology attorney and college professor.

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