A health information exchange, or HIE, is an electronic collection of health information that is securely shared among clinicians and health organizations. There are three main forms of HIEs: Directed Exchange, Query-Based Exchange, and Consumer Mediated Exchange. A Directed Exchange is exchanging info among clinicians to help coordinate care. Query-based Exchange is when clinicians find or request patient info from another clinician. A Consumer-Mediated Exchange is when patients collect and control how their health information is used and shared among their care team.
In addition to the main forms, HIEs can also vary by geography, structure, and governance. For geography, HIEs can cover a large area, such as an entire country or multi-state region, or a small one, such as a city and its suburbs. The structure of HIEs vary. Some HIEs act as a channel sending information from place to place, while others are just big storage sites for all the information. The type of data HIEs collect and services they offer also varies.
What Can We Use HIEs For?
Sharing information through HIEs can improve care efficiency and patient experience. It’s not always quick or easy to share patient information, especially when clinicians are at different locations and using different EHRs. Sometimes, information is shared over the phone or faxed, which can take a long time, and if the patient is already seeing the clinician, the clinician has to care for the patient without any patient history. This is where HIEs can help, by quickly providing patient information without the need to play phone-tag or wait for faxes.
HIEs help clinicians view more complete patient information. If a patient goes to urgent care or sees a new clinician and that clinician does not have any previous patient notes available, the clinician can use the HIE to learn more about the patient’s medical history. This can help the current clinician make the most-informed assessment of the patient and create a better treatment plan.
Sharing clinical data between clinicians and public health agencies also improves population health. The data from HIEs can be analyzed to find patterns, and then these patterns can help influence clinical decisions. For example, HIE data may be able to point out a subset of people that are at higher risk for a chronic condition, such as diabetes. When the clinician sees a patient that is considered high risk, the clinician is notified, and they can do detection tests or preventive measures to help prevent issues or detect them early.
Making HIE Data Actionable
The structure of HIEs vary. Some HIEs act as a channel sending information from place to place, while others are just big storage sites for all the information. While HIEs are a great source of data, having a sea of unorganized data isn’t always helpful. Clinicians already have enough information to sift through (including patient notes, where over 50% of the note is duplicated from the previous one), and they are short on time. They may be interested in the HIE data, but if they have to log into additional softwares and then spend time searching for information, are they going to do it? This is where tech comes in. Digital health technology can partner with HIEs to improve healthcare.
Health tech can take this data from the HIE and bring pertinent information to clinicians at the right time within their clinical workflow. This way, the data can help clinicians make better clinical decisions, without adding extra time and frustration trying to search for it themselves. Whether a clinician wants to view data from a recent acute care stay, or use predictive analytics to suggest preventive screenings for at-risk patients, health tech can pull this information from the HIE data and bring it to the clinician at the point of care.
Here is an example of how HIE can be made usable for clinicians. For example, a patient is transferred to a skilled nursing facility. The clinicians at the SNF look for the patient’s chart and realize a lot of the information is missing. Before, they would try to call the hospital and ask for the rest of the information to be sent over. But phone-tag ensues, and it takes hours for the information to arrive, meaning the clinicians have to care for the patient with the information available. However, health tech and HIE data could work together and change this situation. The patient came in with an incomplete chart, but with the patient’s name, the health tech searched through the HIE data and was able to pull up the most recent information from the patient’s hospital stay without the clinician needing to spend time searching for all the information from various sources. While clinicians still want the full chart, this information helps them provide better care for the patient.
CareAlign can help make this data actionable. CareAlign is partnered with the HealthShare Exchange (HSX) platform to help empower clinicians across Pennsylvania, New Jersey, and Delaware to provide the best care with a more complete picture of the patient. This allows us to take valuable HIE data and bring the right information to the right clinicians at the right time.
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