Ask Joy: This Week – HIEs Why and How to Connect
I’m new to all of this talk about Health Information Exchanges. Why and how should I connect to an HIE?
Let’s start at the beginning and work our way up.
Health Information Exchanges (HIE) offer a secure method of sharing vital patient information electronically and are becoming a key component for providers to connect to hospitals, labs, or other local facilities. In other words, they are a crucial puzzle piece, responsible for opening up a path to interoperability. And interoperability is a major part of the national health goals and are heavily relied upon to meet Meaningful Use. For a thorough review of HIEs, I recommend listening to this Learning Lunch on Health Information Exchanges to understand the distinctions among the different types of HIEs available as well as the benefits and challenges in reaching interoperability.
HIEs have a lot to offer. They allow for successful transitions of care, submissions of immunization data to immunization registries and syndromic surveillance data to public health agencies. In fact, a good deal of Meaningful Use objectives require the provider to utilize the services of an HIE. They include:
- Registry Reporting / Reporting to Public Health
- Electronic ordering of medication, labs, radiology
- Health Summaries for Continuity of Care
- Receive Public Health Alerts
- Home Monitoring
- Population PHRs
HIEs typically connect the various stakeholders involved in the healthcare environment, including:
- Provider to Laboratory
- Pharmacy to Provider
- Office to Hospital / Vice Versa
- Office to Office
- Office to Patients / Vice Versa
- Hospital / Office to Public Health / Vice Versa
- Hospital / Office to Reporting Entities
- Hospital to Patient
If you’re not already connected to an HIE, your first step would be to check if your EHR vendor is listed in the UC Davis project HIE Ready. It’s a buyer’s guide for physicians that discloses EHR vendor’s capabilities to connect to an HIE.
If your EHR is on the list, take the next step and find your community, regional, or state HIE by visiting the HIMSS State HIT Dashboard. From this dashboard, you can filter the map to show only Health Information Exchanges. Click on your state, then click on the HIE nearest to your practice. Each HIE registered on this map should include more information about the services they provide as well as contact information to get signed up. If the information is minimal, consider re-filtering the map to find your Regional Extension Center and contact them for guidance.
The good news is that the HIE landscape is steadily growing. There is at least one HIE in every state, with the exceptions of Wyoming, Arkansas, and New Hampshire. The states with the most available HIE options are New York, Michigan, California, and Florida. In total there are 199 HIEs nationwide. Sixty-five of those support ACOs, 90 offer direct messaging as a service, and 37 allow for patients to view their records online, which could help providers meet the Stage 2 requirement of 5% of patients to view, download, or transmit their medical records electronically.
Exchanging information comes in lots of shapes and sizes. As a provider, you have a lot of choices when it comes to selecting an HIE: statewide or community wide, public or private. It’s important to note that not all HIEs provide the same sets of services or have the same business model. Participation will likely require a membership fee or a transaction cost as well as a Business Associate Agreement to ensure protection of privacy for patient information.
Don’t be surprised if your practice needs to join multiple HIEs in order to meet all of your needs.
For further reading on getting up to speed on HIEs, check out:
HIE: What Providers Need to Know
HIE and Meaningful Use Stage 2 Matrix
Regional Health eDecisions: A Guide to Connecting Health Information Exchange in Primary Care
About the Author: Joy Rios has worked directly with multiple EHRs to develop training programs for both trainers and practice staff. She has successfully attested to Meaningful Use for multiple ambulatory practices in both Medicare and Medicaid. She also authored the Certified Professional Meaningful Use course for www.4Medapproved.com. Joy holds an MBA with a focus in sustainability. She is Health IT certified with a specialty in Workflow Redesign, holds HIPAA security certification, and is a great resource for information regarding government incentive programs.Ask Joy is a regular column on 4Medapproved HIT Answers.