Health Information Exchange
What is health information exchange (HIE)?
The electronic movement of health-related information among organizations according to nationally recognized standards.
For more details, visit:
http://www.nahit.org/pandc/press/pr5_20_2008_1_33_49.asp
How can HIE help my practice?
HIE leads to a wide range benefits for medical providers. These include:
- Supports improved decision making through better access to data and records and built-in analysis tools.
- Reference: I. Sim et al (2001). Clinical Decision Support Systems for the Practice of Evidence-Based Medicine. J. Am. Medical Informatics Assn. 8(6), 527-534
- Reduces medical errors and helps avoid adverse drug events.
- Reduces costs. Examples of the quantifiable savings realized by implementing electronic health records (EHR) include:
- Patient access leads to fewer missed appointments
- Billing accuracy and coding guidance
- Potential for eliminating transcription cost through voice recognition software
- Paper trail reduction
- Staff may use their time more efficiently
- Medical record storage/archiving
- Improves continuity of care, particularly for individuals with multiple conditions and multiple providers.
- Availability of information in case of trauma or accident away from home.
- Consumer empowerment by making information patient-centric and accessible to the patient.
- Improved communication with providers, particularly for people with chronic conditions.
- Improved safety.
For more details, visit:
deloitte.com/dtt/cda/doc/content/us_chs_hie-businessmodels_111306(1).pdf
“The Promise and Challenge of Health Information Exchanges” by John Glaser, Ph.D.
healthunity.com/handbook_rhioarchitecture.aspx
Summary of proposed architecture for health care information networks (HIEs and regional health information organizations RHIOs) by HealthUnity
library.ahima.org/xpedio/groups/public/documents/ahima/bok1_034250.hcsp?
dDocName=bok1_034250
“Selling Physicians on EHRs: Illustrating the Benefits to Care, the Importance of Data” by Chris Dimick
iom.edu/CMS/8089.aspx
“Crossing the Quality Chasm”, Institute of Medicine
citl.org
Center for Information Technology Leadership
pharmacist.com
American Pharmacists Association resources on patient medication safety
ashp.org/Import/PRACTICEANDPOLICY/PracticeResourceCenters/
PatientSafety.aspx
American Society of Health-System Pharmacists
ehrbestpractice.com
EHR Best Practice Series™ for successfully navigating the Electronic Health Record (EHR) selection and implementation process
leapfroggroup.org
Leapfrog Group for Patient Safety
Do I need an EHR to participate in electronic health information exchange?
No, you do not. EHRs offer providers the flexibility to start slowly and add functionality as you go. For example, you can participate in ePrescribing by linking to a secure portal offered by health systems and pharmacy organizations.
You can also receive results securely via a portal offered by health systems and the labs/imaging centers that perform the procedures. In addition, you can participate in health information exchange through a local regional health information organization (RHIO) that provides a community portal to access health care records.
For more details, visit: himss.org/rhio_connection/20070405_RHIO_Connect.htm
healthtransformation.net/cs/state_solutions
http://www.cms.hhs.gov/eprescribing/
http://www.himss.org/ASP/topics_eprescribing.asp
Will participating in the HIE give state and federal government additional access to the medical records of my patients?
State and federal reporting laws already require health care providers to disclose the sharing of certain health information without an individual’s authorization to agencies monitoring and tracking public heath issues. Such releases are permitted under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule under either the "public health" disclosure exception, or because they are "required by law." It is also important to remember that the HIPAA Privacy Rule allows for the disclosure of protected health information (PHI) without an individual’s authorization for Treatment, Payment and Operations.
For more details, visit:
http://www.hhs.gov/ocr/hipaa/
How does HIE impact Pay for Performance?
Professional medical societies generally support incentive programs to increase the quality of health care, but express concern with the validity of quality indicators, patient and physician autonomy and privacy, and increased administrative burdens. The Center for Medicare & Medicaid Services (CMS) is developing and implementing a set of pay-for-performance initiatives to support quality improvement in the care of Medicare beneficiaries.
Pay-for-performance is in its early stages of development and a great deal of work still must be done to determine the best method of approaching a comprehensive program. CMS will provide technical assistance to those states that voluntarily elect to implement pay-for-performance programs. We also plan to work with states to encourage that evolving pay-for-performance programs include an evaluation component to provide evidence of the effectiveness of this methodology.
For more details, visit: http://www.cms.hhs.gov/apps/media/press/release.asp?counter=1343
Do Stark laws prohibit me from participating in HIE?
No, recent exceptions adopted to the Stark Law now allows for hospitals to invest in software and hardware for physicians without violating the Stark Law.
For more details, visit:
http://www.himss.org/content/files/Stark_regulations_101507.pdf
Are there other physicians willing to help me learn more about acquiring and using standards-based EHRs and health information technology (HIT) to improve my practice?
Yes, the Physicians' Electronic Health Record Coalition (PEHRC) is a coalition that helps physicians acquire and use affordable, standards-based electronic health records (EHRs) and other health information technology to improve quality, enhance patient safety, and increase efficiency.
For more details, visit:
www.pehrc.org/
