Health Information Exchange

HealthInformation Exchange




HealthInformation Exchange

Healthinformation exchange is the sensitizing of healthcare informationamong organizations in a particular region, community or hospitalsystems via electronic means. The organization that facilitates theexchange is also may also be called the HIE. Doctors, medicalofficers, and their patients can be able to share vital informationin a discrete manner through the system. In most cases, the medicalinformation is kept on papers despite the availability of secureelectronic data transfers channels. Information to be transferred tovarious medical personnel is done through mailing systems, faces orsometimes the patients are to carry the files on every appointmentwith the doctors. Although HIE cannot gradually replace thecommunication between the patients and the medical officers, it hasthe potential to improve the completeness of the medical records.

Historyof HIE

Inthe United States, there has been an effort to establish the healthinformation exchange running for over many years. In the process,there was the foundation of another system that was aimed atencouraging the formation of a central information center for somedefined communities. The system was known as the Community HealthManagement Information System. The Institute of Medicine Report cameup and identified the medical errors as a potential threat to theAmerican health and that it could be addressed. There then came up anew generation of federal efforts that was willing to address theissue by making use of the information technology. Many organizationswere then founded and were seen to support the mission of improvingthe information systems in healthcare through funding. In the processof the funding initiatives, the HIE was established in variousmarkets and vast academic settings (Hoyt &amp Yoshihashi, 2014).Some of the known parameters include the Health Bridge, and theIndiana . There was also another despisedsetting of information exchange other that the exchange betweenproviders such as the large integrated delivery networks.

Thedefinitions of the health information exchange were changing fromtime to time changing the understanding of the system. HIE and RHIOwere used interchangeably for many years at the time when the ONC wascreated. After the difference in the opinions, there came theNational Association for Health Information Technology. Theassociation was seen to publish some of the definitions of the majorIT terms and also standardized and distinguished the definitions ofHIE and RHIO. HIE was branded the process by which health informationis exchanged, and RHIO branded as the regional center where theorganizations can exchange information. From then, it has sincebecome apparent that the central infrastructure to support theexchange of the health information is not necessarily regional.

Benefitsof HIE

Technologyhas been a critical tool enabling the achievement of healthinformation exchange. HIE has allowed healthcare service providersand patients to access and share critical medical information throughelectronic media. The concept has several benefits to the serviceproviders as well as the patient’s in different ways i.e. improvingsafety, speed and cost of care. In order to improve healthcare, thefederal government have developed policies and actions that requirethe healthcare providers adopt the health information exchange. HIEprevents the fragmentation of patient information that acts as achallenge towards assisting different patients. Through the policy,the health care providers will have the ability to share medicalinformation with the patient to improve the care given. HIEinfluences the efficiency of the care provided to patients. Access tothe patient information in real-time can significantly help thedoctors in making timely decisions and providing quality care basedon the patient’s health background.

Healthcare providers tend to utilize less information from the personalhealth system. They fail to understand the effectiveness of usingpersonal health information for delivering quality and efficient caresince the information is fragmented across various databases such aslaboratories or pharmacies. HIE is aimed at reducing the fragmentedinformation ad developing a central location where information can beshared in real-time to assist patients. Sharing information allowsthe doctors to improve their safety since it can add potentialrelevant information for the specialty care. On the other hand, HIEhelps in resolving severe pandemics since it requires the healthcareprofessionals to identify the health information of the patientsbefore administering drugs. HIE makes patient information availableto different institutions such as research institutions thusimproving the quality of care provided. The organizations shareinformation related to the patient’s performance allowing thedoctors to improve the quality of care (Vest &amp Gamm, 2010).

Theaccess to health information for the patients helps the professionalsto be better informed in decision-making i.e. improving diagnosis. Inaddition, HIE can also help the doctors to avoid readmissions andmedication errors since the information is reviewed periodically.Information sharing also reduces duplicate testing. Informationsharing allows coordinated care that has a significant impact on boththe patients and healthcare providers. The direct exchange used canbe critical in sharing valuable data to avoid duplicate testing. Inaddition, the doctors can prevent adverse medication reactions byaccessing recent patient information. HIE also significantly helps inreducing the cost of patient care as data is electronicallytransferred to specialized doctors to assist the patients rather thansending the patient to another facility (Roebuck, 2012).

HIEprovides the patient access to the health information thus allowingthem to manage their health care online. As a result, the patientscan actively participate in their care coordination through provingthe doctors with their health information. The patients can alsoassist in identifying any missing health information as well asmonitoring their health. Health information exchange makes fullutilization of the personal health information due to the centrallocation and storage of data. It reduces the isolation of patient’shealth information thus addressing the barriers to effective caremanagement. On the other hand, the exchange of information fosterscollaboration among competitors by providing centralized datarepositories and a network approach that can be used by thecompetitors to improve the quality of care. HIE also supplementsother existing strategies to improve the quality and reduce costsrelated to healthcare. The technology in healthcare can cover a widergeographical area such as the rural and urban setting allowingefficient management of the patients to the local providers (Melvin,2010).

Privateand security concerns of HIE

Theelectronically developed information system is designed in a way thatthey cannot interact with each other. It is, therefore, necessarythat some policies and procedures had to be addressed so as to have asmooth and secure information exchange. First, the participants inthe data exchange activities should agree on the practices to befollowed. It will ensure that the information will revolve only amongthe authorized users within the institution. When this is followed,there will be high assurance of the security of the data other thanwhat technology provides. In any cases where the applications of newdata exchange models are considered, the main focus should be on theprotection of the already existing data. The security should beshould be in place throughout the new connections and relationships.When the data is exchanged between the different entities, theprimary focus should be on the health information system. It has beennoted that immediately a patient’s data leaves the source theproblem do arise even when there is a formal entity governing theexchange (Harman &amp American Health Information ManagementAssociation, 2006). It is a mandatory requirement that the privacyand security of the data are maintained. The access and use of datashould be monitored at all costs, and all malpractices are addressedin the clinical officers and also the economic impacts to beassessed. After learning all the information, it is clear thatawareness should be created between the state and community levelswhen discussing health IT and HIE. There should be a common groundset on the principles and policies that can be employed by theparticipants during the exchange.

Policyand Technology Solutions.

Inorder to achieve a safe information exchange, there should be somepolicies over some issues put in place. Data use should be limitedthe data ownership should be defined. And the roles andresponsibilities of the individuals and organization should beclearly stated. According to the previous experiences, in thelarge-scale information exchange, linking policy and technology ishighly recommended. It is clear that implementing a change withoutvalid systems is quite impossible. On the other hand, no soundpolicies can be implemented without a clear understanding of thetechnicality of the exchange. The major challenge is the technicalityof linking information across a diverse and highly fragmented healthcare system. The policy challenge can be affected by the technologyused, the market economy or even the manner in which the system wasdeveloped.

Privacyand Security

Themaintenance of the public trust in the electronic data exchange is akey are that brings a tough debate between the state and communities.The HIE will be very effective and efficient when the staff finds theinformation needed instantly. There will be no mistakes as theinformation will be readily available, care will be improved and manylives will be saved. According to survey reports, a good number ofthe Americans are worried about the privacy of their healthinformation. It is, therefore, necessary to develop and employtechnical and policy approaches to ensure the safety of theinformation.


LimitedDemand For HIE

Oneof the challenges is that providers consider health informationexchange as valuable but not essential. Among the many priorities inthe vendors list, health information system is found to appear in thebottom last options of the list. The providers have been spottedgiving a lot of attention to other systems like the EHRs but notputting similar efforts to HIE. The reason is that HIE does notrequire the providers to engage in the exchange but only to havecapabilities for HIE. Many states have been seen to put up someefforts to expand their exchange capabilities without demand ormotivation for HIE.


Sustainabilityalso remains another key challenge to the health informationexchange. Many states have raised financial sustainability as aprimary concern regarding the health information exchange. There isno clear indication of what providers will offer their services tothe HIE. It is not even clearer if there are any providers willing toprovide their state-offered services towards the health informationexchange once program funding’s end. Some of the providers who havelimited funds for the information exchange are reluctant to use theirservices (Zwaanswijk &amp Friele, 2011). The reason is that there isthe lack of evidence on whether the services will be available in anextended time thereby threatening the long-term viability of stateservices.

ClinicalWorkflow Issues.

Thereare complaints from the representative of provider organizationsconcerning the information exchange. It is said that the data is notconsistently updated into the patient’s records and workflow. Theseissues have prevented the provider’s from seeing the benefits ofhealth information exchange. The integration of electronicallytransferred data has been accompanied with a lot of issues. At thepoint-of-care, there has been witnessed poor usability design of theEHR systems. The available technical standards have also been usedinconsistently in the exchange of clinical care summaries. Theseissues are considered universal and should be addressed so at tomotivate the provider organizations to offer their support towardsthe health information exchange.


Thestakeholders in the state were seen to work hard to establish a widersustainable HIE that was under the HIE cooperative agreement program.It was seen that various approaches were being put in place that werebeing developed by the HIE aside from the program. There was a methodthat was meant to support the decision made by the federal policymakers in the designing of the state-level program.

Therewas also the formation of a sustainable primary and common groundthat was supportive of the success and challenges today. There was asignificant move that was using the policy and law to handle thebarriers to the health information exchange. The lowering of thebarriers was not good enough to tackle the issue of lack of demandfor HIE. It was until the stakeholders treated HIE as a base to theirbusiness models. Without that achieving, a sustainable foundationwill be so impossible. There was a necessity to address the widervariety of barriers so as to make a successful health informationexchange. The government has the responsibility to formulate codesthat will assist health information exchange in handling therestrictions. States can successfully enact laws and policies toaddress certain barriers if they could get some support from theprogram. Considering the issue of policy and privacy, focusing moreon the data ownership and use, states who have not formulated lawsconcerning them should do so in order to increase the security ofdata transfer. Implementing policies on matters affecting theworkflow will also increase the effectiveness of the healthinformation exchange.


Fromthe research study, a lesson learned is that the health sector needsmore attention so as to give quality services to the citizens. Thereshould be joint efforts put together to ensure the successfulimplementation of health information systems. There should be aportal where the records of the patients can be safely transferredand kept where they can easily be found at any time when they areneeded.


Harman,L. B., &amp American Health Information Management Association.(2006).&nbspEthical challenges in the management of health information.Sudbury, Mass: Jones and Bartlett Publishers.

Hoyt,R. E., &amp In Yoshihashi, A. (2014).&nbspHealthinformatics: Practical guide for healthcare and informationtechnology professionals.

Melvin,V.C (2010). ElectronicPersonal : Health care Entities’ reported disclosure practices and effects on Quality of care.United States Government Accountability Office.

Roebuck,K. (2012). HIE- : High-impact Strategies – What You Need to Know: Definitions, Adoptions, Impact, Benefits, Maturity,Vendors.Dayboro: Emereo Pub.

Vest,J. R., &amp Gamm, L. D. (2010). Health information exchange:persistent challenges and new strategies. Journalof the American Medical Informatics Association:JAMIA,17(3), 288–294. doi:10.1136/jamia.2010.003673

Zwaanswijk,M., Verheij, R. A., Wiesman, F. J., &amp Friele, R. D. (2011).Benefits and problems of electronic information exchange asperceived by health care professionals: An interview study.BMC Health Services Research, 11,256. doi: