What Are Health Information Exchanges?
According to the Assistant Secretary for Technology Policy, HIEs allow “doctors, nurses, public health professionals, pharmacists, other healthcare providers, and patients to appropriately access and securely share a patient’s vital medical information electronically — improving the speed, quality, safety, and cost of patient care.” HIEs can be run by national, state, regional or local organizations.
However, each HIE has its own methodologies for data sharing, which could lead to nearby health systems having data in discrete formats. A patient might see doctors at two separate organizations, and those providers could be seeing different information.
Getting HIE organizations to agree on an exchange methodology has been difficult. This has led to the government stepping in to advise them to create a standard methodology, especially because the data has implications on reimbursement.
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HIE participation has several benefits, such as supporting informal clinical decision-making by giving providers access to external lab results, imaging discharge summaries and medication histories at the point of care. This can translate into safer care, less duplicate testing and smoother transitions across care settings.
A larger goal of HIE participation is to improve quality reporting, support public health initiatives and increase healthcare’s adoption of value-based care. Ensuring that patients receive the right care up front not only makes them healthier but lowers care costs overall. Both insurers and the government have an interest in ensuring patients get the best care for the best value.
However, to participate in an HIE effectively, health systems must address data quality, which encompasses standardization, governance and consent. Without that investment, HIEs can become a source of noise rather than a true clinical asset.
How Can Healthcare Organizations Prepare for HIE Participation?
To participate in an HIE, healthcare organizations need a clear data governance framework that defines roles, accountability and decision rights across clinical, IT, compliance and operations. It should be a systemwide initiative rather than siloed into a specific part of the organization.
An effective framework should address:
- Data quality
- Terminology
- Coding standards
- Patient consent workflows
- Privacy and access policies
- Escalation paths for data issues
Healthcare organizations should be treating data governance as an executive-level responsibility rather than purely an IT initiative. That’s crucial to ensuring that the exchange is trusted, actionable and aligned with organizational risk and compliance expectations. Ultimately, data governance and HIE participation should be board driven, with acceptance across the system to set up the initiative for success.
On the technology side, healthcare organizations need an electronic health records system at minimum to participate in an HIE. For the best benefit, the EHR should be a modern system with interoperability standards, such as HL7 or FHIR. That would allow the organization to utilize interface engines and integration middleware that normalizes routes and transforms the data between internal systems and the HIE.
DISCOVER: How does minimum viable data governance enable smarter healthcare?
In addition, accurate patient identification management, robust security capabilities, access controls, audit logging, encryption and, increasingly, cloud-ready infrastructure are important to participate reliably and securely, especially as the industry moves toward a national exchange service.
Artificial intelligence is shifting the focus in healthcare from simply exchanging data to making that data more actionable for clinicians and operations. Common use cases include automated data normalization, deduplication, clinical summarization or large document sets, intelligent relevance filtering for clinicians and improving patient matching and record linkage. These capabilities afforded by AI can help reduce information overload by surfacing the most important insights at the point of care to unlock more value from the data flowing through HIEs.
Strategic Partnerships Help Health Systems Navigate HIEs Effectively
Partnering with a trusted data expert such as CDW can help healthcare organizations move from merely connecting to the HIE to deriving measurable clinical and operational outcomes. We offer services such as HIE readiness assessments and data governance strategy. Governance is a huge part of what we do and includes standardization, integration, architectural design, security, compliance, alignment and organizational change management.
In addition, CDW can guide the healthcare strategist team on further conversations with IT executive leadership to help create a roadmap for where they want to be.
CDW also can help healthcare organizations plan for what’s next, such as the national interoperability framework, advanced analytics or AI-driven use cases so that HIE investments are sustainable, scalable and tightly aligned with strategic care and business objectively. We can even help small systems find nearby health systems to partner with if they’re unable to afford HIE participation on their own. Improving outcomes is the ultimate goal.
This article is part of HealthTech’s MonITor blog series.
