There has been lots of talk the past few years about the
changes to healthcare and how it’s delivered.
One of the driving forces of this change has been the desire to reduce
the cost of delivering healthcare services while at the same time producing better
outcomes for patients. Health
information exchanges, or HIE for short, are one tool which can help drive these
changes.
In its simplest form, an HIE allows your doctor to share
your medical information with medical professionals in other organizations. Just how this is accomplished and what
information is available is dependent upon how the HIE is setup.
An HIE may be structured to allow your doctor
to send lab or radiology orders to a hospital, and those departments can in
turn electronically send back your results when available.
It may also be set up so your doctor can send your medical information
to another doctor, such as a specialist you’ll going to visit. Your information could also be made available
so in case you need to go to the emergency department those doctors can access
your information even if your own doctor’s office is closed.
An HIE is accessible only by users who have been given
access, and they only have access to information which their user account gives
them rights to access. For example, it
is typical for emergency room physicians to have special access to records in
cases of emergency. But a physical
therapist wouldn’t automatically have access to mental health information.
Information is made available to an HIE when a doctor’s
electronic medical record (EMR) software is given access to the HIE. The doctor then makes patient information
available to the HIE. Typically patients
are provided with a form to sign stating whether they wish to make their
information available on the HIE or not.
Depending on the state and the healthcare organization, this will take
the form of an opt-in or opt-out authorization.
An HIE can be privately run, such as by a hospital, or publicly run, such as by a state. And
an HIE can be connected to another HIE. For
example, multiple hospital systems can be connected through a state-wide HIE. Whoever is in charge, the cost of the HIE is
born by that organization and it will typically charge a fee to subscribers (your
doctor or hospital) to access the HIE. Patients
are not directly charged for making their information accessible to an HIE.
HIE’s can be very helpful because in the past sharing
patient information between organization has been inefficient and
cumbersome. When a patient was referred
to a specialist, someone had to copy the patient’s medical file and mail or
courier it to the specialist. Or someone
had to take the medical file apart, fax it, then reassemble it and file it
way. It may not sound time consuming,
but when this is repeated multiples times per day every day, it is time
consuming and expensive. Plus, there’s
usually a time delay because the doctor must first update the medical record,
and if it was done through transcription it could take days before the record could
be mailed or faxed. Additionally,
sometimes radiology films and other media end up in the wrong office or not
returned to the primary care physician’s office and are lost.
Finally, don’t confuse the term “health information
exchange” with “health insurance exchange”. A health insurance exchange is a place
where patients can shop for health insurance.
A health information exchange is where doctors can share patient
information with other doctors.
So that’s a very simple explanation of a health information
exchange. For more information I’ve
provided links to additional resources below.
