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Health Information Exchanges

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Health Information Exchanges Vary Across the Country

More physicians and clinical practices are adopting Health Information Exchanges (HIEs), and it is important to know that not all HIEs are the same. The governance, structure and geographic scope of HIEs vary across the country.

  • Geography: Some HIEs serve a small geographic region, while others serve an entire state or multi-state region.
  • Structure: Health Information Exchanges can also differ in technical models, with some acting as conduits of health information and others serving as repositories of health data.
  • Governance: There is also wide variance in the types of clinical data exchanged, services offered and legal infrastructure associated with HIEs.                            

First Steps in Selecting an HIE

Before selecting an HIE, it is important to look at the advantages and disadvantages the HIE provider brings to the table. Keep these things in mind:

  • What type of services and functionality does the HIE cover?
  • What are the financial costs?
  • What are the liability concerns?

Who Has Access to the Data

Data access and use varies between HIEs and it is critical for physicians to establish who has access to what data within the HIE and how that information will be used.

Meaningful Use (MUs) and HIEs

Stage 2 Modifications requires participating hospitals and physicians to exchange health information  with each other, sites of service and with their patients. Although Stage 2 Modifications measures are considerably more complex than previous stages and participating remains low, the use of an HIE can help meet some of the measures.  The AMA has prepared a summary table of where Stage 2 and HIEs intersect (PDF, sign-in required). For more information, visit the Meaningful Use page.

Alternative to HIEs

The Direct Project (PDF) may be an alternative for physicians who want a system that provides basic electronic health information exchange. It can send and receive information, such as summaries of patient records, if both parties have systems that support the Direct Project. The Direct Project sends electronic messages similar to email, with encryption  that meets HIPAA standards.  

Unlike a fully functional HIE, physicians cannot query for certain information using Direct Project.  The Direct Project  allows for the secure exchange of data between 2 points (such as  physician to physician or physician to hospital).  The Direct Project’s capabilities are not as sophisticated as a fully functional HIE, but offers some opportunities for basic electronic health information exchange between providers.  For more information on capabilities and costs, talk with your EHR vendor. 

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