Tuesday, July 31, 2012

The Informed Patient: What’s a health information exchange and why should I care?


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.

 

 

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