What is the Health Information Exchange (HIE)?

The healthcare industry has been changing dramatically over the last decade, owing its evolution to technology that helps advance patient care and management. One example of these advancements can be found in the Electronic Health Information Exchange, also known as the HIE. The term HIE can be used as either a noun or a verb. As a noun, it relates to any organization that offers the technology to allow for digital access and transfer of a patient's medical records. As a verb, it relates to the direct electronic sharing of medical information between healthcare professionals.

The health information exchange allows doctors, nurses, pharmacists, and a variety of other healthcare providers—and the patients they serve—secure electronic access to a patient’s health information. Historically, this health information has been paper-based, making it difficult to share across departments and facilities as patients continue their care regimens by collaborating with therapists, pharmacists, and more. Now, instead of printing, mailing, and faxing health information, healthcare professionals can easily share this health information electronically with colleagues as needed. Similarly, patients can also benefit from the health information exchange by having easy access to their own medical records without having to keep files or boxes full of documents that they have to carry from appointment to appointment.

Overall, this digital approach to patient health information management is considered a quicker, safer, and more cost-effective approach to patient care. And as more medical and healthcare facilities are relying on new technologies such as the HIE to manage patient documentation, there’s an increasing need for IT professionals to help them migrate from analog to digital.

There are three main types of HIE, each one designed to give healthcare providers and their patients the kind of health information they need, exactly the way they need it. These types are:

• Directed Exchange: This type of health information exchange allows medical professionals the ability to send and receive secure documentation over the internet using secure, encrypted messaging. Using this method, information that can be shared includes lab results, discharge summaries, patient referrals, and more. This kind of information exchange is critical in interoperability for all kinds of clinical conditions across many different entities. Patients benefit from this type of electronic exchange because participants can get direct clinical referrals and their conditions can easily be explained to other providers with ease. EHR exchange typically happens through directed exchange.
  
• Query-Based Exchange: When healthcare providers need further information on a patient and their medical history, this approach allows them to request information from other medical professionals. This information exchange tends to be used during emergency care situations. If a provider is unsure about the situation surrounding a birth, operation, or other medical event, they can use a query-based information exchange to better understand what happened at one entity or another. If a doctor needs to understand the symptom that lead to a lack of oxygen or a seizure, they will ask another provider to exchange the information so they know what areas of the brain or what other care options they should pursue.
  
• Consumer-Mediated Exchange: Patients are granted the internet access they need to manage their own health information, allowing them to transfer their information as needed to their provider of choice. They can also correct and update their own personal information as needed and use their medical information to help them maintain their health. This kind of health information exchange helps with interoperability and allows patients to take control of their public health and EHR. Health is personal and patients who have the ability to choose their provider and give them the health information they need are able to feel more confident in their care and decisions.
  

Though it may be challenging for some medical facilities to transition from an analog approach to digital, there can be numerous benefits associated with employing the health information exchange. Some of these health and associated benefits include:

• Improving communication between departments and care providers, which can result in a reduction of errors
  
• Reducing costs by cutting out supplies needed to maintain analog files and speeding up the lines of communication
• Offering healthcare professionals a more complete view of their patient so they can offer more effective care options
• Furthering patient education by making them more involved in their own care
• Reducing or eliminating unnecessary testing
• Offering more opportunity for feedback related to research pursuits from clinics and practices
• Boosting public health reporting, which can assist with situations that require monitoring and contact tracing
• Connecting with electronic health records (EHRs) used by individual health organizations, physicians, and other medical professionals
• Making the facility operate more efficiently by reducing and eliminating unnecessary paperwork
• Creating more opportunities to explore cutting-edge technologies and services that can improve patient care
• Timely sharing of patient information to avoid medical errors and readmissions and improve diagnoses

For as many benefits as there are with a healthcare organization adopting the health information exchange, some still face challenges in taking the plunge. Some of these challenges include:

• Expenses related to the transition process that turns their analog file management system into a digital one
  
• Privacy and security concerns, as the digital format can be vulnerable to cyberattacks and account breaches
• Adhering to state and federal regulations related to data management and security, which can sometimes be contradictory or unclear
• Patients withholding information, as some may be reluctant to share their private medical history on a digital platform
• Sharing information across state lines, as differing privacy rules could make it difficult to comply when trying to share patient medical history across the country
• Communication issues between facilities who may not keep the same kinds of records or have incomplete records
• Competition from other medical facilities
• Issues with training and user error, where some medical professionals may have difficulty embracing the new digital format
• Finding the right IT support to navigate and maintain the new digital format

The term interoperability relates to how systems and devices exchange and interpret data. In the case of the HIE, that can encompass how it interacts with the electronic health records that a facility or organization already has and how those records are transferred and shared between medical professionals. The data they share needs to be presented in a format that’s understandable and accessible, which is what makes it interoperable. This also means that the data in question needs to meet certain standards to be shared in a variety of different healthcare settings, using strong security protocols to ensure the data is protected.

One of the goals of implementing the HIE is to standardize data practices so that a patient’s medical information is easily processed by each individual medical facility, which can cut down on miscommunication and strengthens patient care practices. No matter who manages or enters the data into the system, it should appear uniform from one practitioner to the next to paint a complete picture of the patient and leave no room for error. This way, every medical professional involved in a patient’s care knows exactly what protocol is being followed, putting everyone on the same page, so to speak—even the patient.

As the HIE evolves alongside the healthcare industry, it’s expected the technology that drives it will continue to advance right along with it, offering new and inventive ways for medical providers to digitally store, maintain, and share patient information. Currently, there’s a drive to make the HIE more integrated across healthcare organizations on a local, regional, and national level, ensuring file sharing is more seamless and compliant with state and federal regulations. One of the formats that’s making the HIE more accessible is a single-platform resource that makes the transfer of data simple and seamless.

The current challenges facing the kind of interoperability the HIE needs are related to the technology itself, which isn’t agile enough to work seamlessly with diagnostic tools and processes. This is complicated by faster deployment of new drugs and treatments, along with a lack of global standard that makes the HIE accessible all over the world. Additionally, there’s also a challenge with a lack of recorded information, where professionals consider their records as proprietary and don’t wish to share them. The HIE can also benefit from stronger confidentiality features that can make patients and their caregivers feel more secure about sharing information.

Regardless, the HIE is quickly becoming the industry standard for record management and transfers, which means the industry needs effective and qualified IT and healthcare information professionals to manage and maintain the system. And with technology driving the future, the HIE will undoubtedly become the centerpiece of the revolution that’s currently transforming the healthcare industry.