Difference between revisions of "Electronic health information exchange"
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| − | ''' | + | =='''Overview'''== |
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| − | + | The efficient, effective and equitable delivery of care is vital to the well-being of patients, their families, and the community as a whole. In order to meet this need and improve patient care, it requires information to be exchanged among various groups so that health professionals have the information they need to make informed decision that impact lives. Electronic health information exchange (HIE) offers a way for clinicians and organizations to electronically send and receive complete patient information between different facilities and systems that would normally not be able to communicate. HIE began at a time where technology, system standards, and health IT vendors used diverse and disconnected programs; creating a barrier to access patient records, health histories, and pertinent laboratory, radiology, and pathology results or orders. This was a significant deficit in quality of care, as it limited clinicians' ability to see the full picture and properly evaluate, assess, diagnose, and treat their patients. About 15 years ago, HIE began to transform into a more mature tool for care coordination, leading to the emergence of the current systems and programs used today. | |
| − | + | ||
| − | + | =='''Pros & Cons''' == | |
| − | 1. | + | |
| − | 2. | + | '''Advantages''' |
| − | 3. | + | |
| − | 4. | + | HIE technology has four main roles in the healthcare field(1): |
| − | + | ||
| − | + | 1. ''Interconnectivity'' -- HIE tools help organizations avoid custom, point-to-point connections, where each provider must create a separate connection to every other system, service, and provider they want to communicate with | |
| − | + | ||
| − | + | 2. ''Clinical document exchange'' -- Efforts taken to ensure providers follow regulations that have established a minimum set of elements that records should only be exchanged to coordinate care; currently filed under the "Continuity of Care Document (CCD)" | |
| − | + | ||
| − | + | 3. ''Creating a community health record'' -- Regional HIEs can consolidate a patient’s health information into a community health record, which is a more complete picture of the care a patient is receiving | |
| − | + | ||
| − | + | 4. ''Encounter notifications'' -- HIE can be used to alert clinicians and other members of a patient's care team to make providers aware of recent encounters, health problems, emergency needs, etc. to ensure proper follow up and intervention is taken | |
| − | + | ||
| − | + | '''Disadvantages & Strategies''' | |
| − | + | ||
| − | + | Issues can be categorized into three groups: technological, fiscal, and organizational -- | |
| − | + | ||
| − | + | 1. ''Technological'' | |
| − | + | ||
| − | 2. | + | The issue surrounding the amount of time it takes for HIE systems to become viable. This technology is complex and requires dedication and collaboration from various fields: architecture, IT, engineering, and healthcare to be successfully built and operational. A recent study of HEAL grantees found that the adoption of both core HIT and HIE occurs over a long horizon. While most grantees were able to begin the HIE process over a two-year period(2). |
| − | 3. | + | |
| − | + | 2. ''Fiscal'' | |
| + | |||
| + | The primary fiscal issue is the lack of a viable business model for information exchange. A recent study of RHIOS by Julia Adler-Millstein, David W. Bates and Ashish K. Jha found that 41 percent of operational RHIOs reported that revenue from participating entities was sufficient to cover costs, and of the remainder, only 28 percent expected that revenue over time would adequately cover costs. Initial funding has been helpful in facilitating the participation of health centers in exchanges, but it does not address the issues of staying in an exchange longer term. Thus, support for ongoing operating costs and financial sustainability over time are important considerations(2)(3). | ||
| + | |||
| + | 3. ''Organizational'' | ||
| + | |||
| + | The technologies and policies adopted are usually structured and generally focused on the needs of the larger organizations. Health centers have different levels of need and may not have the time or the staff to dedicate to the planning and decision making of these policies(3). Thus, the facilities that have the necessary coverage will be, and are better served -- which is a key trade-off for health center participation in an HIE system. | ||
| + | |||
| + | =='''Protocols & standards'''== | ||
| + | |||
| + | [[HIPAA]] | ||
| + | |||
| + | The purpose of HIPAA is to improve the efficiency, effectiveness, and security of the national health system. | ||
| + | |||
| + | Increase efficiency: paper work is reduced for healthcare providers due to an electronic system. | ||
| + | |||
| + | Reduce fraud and abuse: digital paper trail makes fraud prosecution easier. | ||
| + | |||
| + | Portability: an employee is guaranteed health insurance coverage, even when he changes jobs. | ||
| + | |||
| + | Security: increased security for patient health information and protect patient rights. | ||
| + | |||
| + | Accountability: protecting health data integrity, confidentiality and availability. | ||
| + | |||
| + | To comply with the security standards, an electronic medical record (EMR) must have written, comprehensive security policies, access controls, control over the physical environment, clearance procedures, and a record of all access authorizations. | ||
| + | |||
| + | =='''Sources'''== | ||
| + | <div class="csl-entry"><i>1. The Oregon Health Authority and Health IT: Health Information Exchange Overview</i>. (n.d.).</div> | ||
| + | <div class="csl-entry"><i>2. Health Information Exchange – An Introduction _ RCHN CHF</i>. (n.d.).</div> | ||
| + | <div class="csl-entry">3. Rhodes, H. (n.d.). <i> Seven Unintended Consequences of Electronic HIE</i>. http://www.healthit.gov/policy-researchers-</div> | ||
| + | |||
| + | Submitted by (LeeAnn Farestrand) | ||
| + | [[Category:BMI512-SPRING-22]] | ||
Latest revision as of 23:34, 13 May 2022
Overview
The efficient, effective and equitable delivery of care is vital to the well-being of patients, their families, and the community as a whole. In order to meet this need and improve patient care, it requires information to be exchanged among various groups so that health professionals have the information they need to make informed decision that impact lives. Electronic health information exchange (HIE) offers a way for clinicians and organizations to electronically send and receive complete patient information between different facilities and systems that would normally not be able to communicate. HIE began at a time where technology, system standards, and health IT vendors used diverse and disconnected programs; creating a barrier to access patient records, health histories, and pertinent laboratory, radiology, and pathology results or orders. This was a significant deficit in quality of care, as it limited clinicians' ability to see the full picture and properly evaluate, assess, diagnose, and treat their patients. About 15 years ago, HIE began to transform into a more mature tool for care coordination, leading to the emergence of the current systems and programs used today.
Pros & Cons
Advantages
HIE technology has four main roles in the healthcare field(1):
1. Interconnectivity -- HIE tools help organizations avoid custom, point-to-point connections, where each provider must create a separate connection to every other system, service, and provider they want to communicate with
2. Clinical document exchange -- Efforts taken to ensure providers follow regulations that have established a minimum set of elements that records should only be exchanged to coordinate care; currently filed under the "Continuity of Care Document (CCD)"
3. Creating a community health record -- Regional HIEs can consolidate a patient’s health information into a community health record, which is a more complete picture of the care a patient is receiving
4. Encounter notifications -- HIE can be used to alert clinicians and other members of a patient's care team to make providers aware of recent encounters, health problems, emergency needs, etc. to ensure proper follow up and intervention is taken
Disadvantages & Strategies
Issues can be categorized into three groups: technological, fiscal, and organizational --
1. Technological
The issue surrounding the amount of time it takes for HIE systems to become viable. This technology is complex and requires dedication and collaboration from various fields: architecture, IT, engineering, and healthcare to be successfully built and operational. A recent study of HEAL grantees found that the adoption of both core HIT and HIE occurs over a long horizon. While most grantees were able to begin the HIE process over a two-year period(2).
2. Fiscal
The primary fiscal issue is the lack of a viable business model for information exchange. A recent study of RHIOS by Julia Adler-Millstein, David W. Bates and Ashish K. Jha found that 41 percent of operational RHIOs reported that revenue from participating entities was sufficient to cover costs, and of the remainder, only 28 percent expected that revenue over time would adequately cover costs. Initial funding has been helpful in facilitating the participation of health centers in exchanges, but it does not address the issues of staying in an exchange longer term. Thus, support for ongoing operating costs and financial sustainability over time are important considerations(2)(3).
3. Organizational
The technologies and policies adopted are usually structured and generally focused on the needs of the larger organizations. Health centers have different levels of need and may not have the time or the staff to dedicate to the planning and decision making of these policies(3). Thus, the facilities that have the necessary coverage will be, and are better served -- which is a key trade-off for health center participation in an HIE system.
Protocols & standards
The purpose of HIPAA is to improve the efficiency, effectiveness, and security of the national health system.
Increase efficiency: paper work is reduced for healthcare providers due to an electronic system.
Reduce fraud and abuse: digital paper trail makes fraud prosecution easier.
Portability: an employee is guaranteed health insurance coverage, even when he changes jobs.
Security: increased security for patient health information and protect patient rights.
Accountability: protecting health data integrity, confidentiality and availability.
To comply with the security standards, an electronic medical record (EMR) must have written, comprehensive security policies, access controls, control over the physical environment, clearance procedures, and a record of all access authorizations.
Sources
Submitted by (LeeAnn Farestrand)
