As the healthcare industry continues to adopt new technologies every day, systems must be put into place to help healthcare professionals manage the data in an effective way. Currently, the most common way that physicians have to share and exchange health data from patients is through Health Information Exchange (HIE) systems. How do HIE systems work, what benefits do they have, and why do we need such exchanges? We’ll look at these questions in more detail and then explore whether the process of HIE in the US is effective right now. If not, what changes are needed?
How Does It Work?
Electronic Health Information Exchange (HIE) systems allows doctors, nurses and nurse practitioners, pharmacists, and other healthcare professionals to access, update, and share patient medical information via electronic data transfer. By making this option available to medical professionals, the speed, quality, cost, and safety of patient care could all see significant improvement.
In spite of the fact that many medical records are now stored electronically, a large majority of patients still carry around their medical records on paper from doctor to doctor. Even doctors sharing data still fax or mail patient records to other providers. HIE systems facilitate the electronic exchange of information, improving the completeness of patient records that medical professionals are able to access. Having a more complete picture of each patient can reduce readmissions, prevent errors in diagnosis or dosage of medications, and decrease the incidence of duplicate or redundant testing.
Why Do We Need It?
The benefits behind electronic HIE systems are not just the speed with which data can be transferred across different providers in different specialties, though this is an important factor. Doctors might argue that faxing the information can be just as effective, especially if there is already a good system and protocol for faxing patient records in place.
The biggest benefit to HIE systems is in the standardization of patient data. With health data standardized, new information (like lab results or test results) can be easily integrated into a patient’s electronic health record, which could potentially help to improve patient care. At the moment, HIE usually takes the form of one of three different exchanges: directed exchanges, query-based exchanges, and consumer-mediated exchanges.
How Is It Working?
Though the HITECH Act was passed in 2009 by Congress in an attempt to help modernize the exchange of health information across the country, there is still a lack of integration of HIE systems. According to a report to Congress in 2018, less than 50% of office-based physicians are able to exchange patient information electronically outside of their own offices, and less than 33% can automatically integrate new patient information into their electronic health records.
Clearly, there’s a need for a solution that offers greater interoperability. Rather than one central HIE network that allows physicians to exchange data, there are often multiple smaller, competing HIEs in different areas. Where geographic borders are less clearly defined, for example, there are often several different HIEs available. There is also some resistance to HIE initiatives from electronic health records vendors and other health systems, who balk at the idea of sharing data (even patient data) with organizations they perceive as competitors. Obviously, resistance from these institutions is a challenge hindering the creation of larger HIEs.
What Needs to Happen?
Earlier this year, the US Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services released draft guidelines intended to improve interoperability of health information. Once finalized, the rules would require providers and insurers serving Medicare patients to make their data electronically accessible by 2020. This is a step in the right direction, but on its own, it cannot solve the broader problem of multiple competing HIEs.
Building a national option for HIE that is available to everyone could be a potential solution. Many advocates of blockchain technology point out that blockchain’s security and organization could make for an extremely effective tool to facilitate the development of one central HIE.
Whatever the particular solution, there is certainly a need for some kind of efficient health information exchange tool with broad accessibility. Errors in care, diagnoses, dosages, and unnecessary testing could potentially be eliminated if healthcare providers had easy, open access to medical records. With the healthcare industry increasingly focusing on improvement of patient care and patient satisfaction, a safe, secure HIE would be invaluable.