Health Information exchanges (HIEs) around the state that are applying for federal grant funds are seeking commitments from local physicians. The number of physician commitments received affects the amount of funding for which the HIE is eligible and becomes part of the funding formula. For each physician committed to a particular HIE, that HIE gets $300. Physicians may participate in more than one HIE, but for funding purposes, physicians can only sign commitment to one.
In basic terms, an HIE is a way to use technology to make patients' health information available anywhere, anytime.
Before committing to participate in a local HIE, physicians need to ask questions. The following questions have been compiled from physician health information technology experts:
- What privacy and security mechanisms does the HIE feature? Physicians should learn what policies and procedures HIEs have developed on how they'll obtain patient consent for use of the data. If a patient chooses to exclude some data from being shared, the physician should ensure the HIEs disclose that fact.
- Does the HIE cover patient populations, encompass referral networks, and include the hospitals and physicians you work with? Physicians should make certain the HIEs they participate in connect with the local hospitals, labs, radiology services, and other facilities. Taking part in an HIE with limited connections could result in a physician making decisions based on partial information.
- Will the HIE be financially viable in the future? It's not simple to move from one HIE to another. Physicians should ensure the HIE they participate in has a thorough business plan with strategies for long-term success and staying power. If the HIE has been in existence for a while, physicians should ask their colleagues about the exchange's track record and functionality.
- Is there a fee to participate? Many HIEs will be free to use initially, but physicians should ask whether potential future fees have been addressed.
- Who is on the HIE board of directors? HIE governance should be representative of health care stakeholders in the community.
- What are the system requirements to connect to the HIE?
- Does the HIE use a centralized model or a decentralized model? Physicians participating in exchanges that use a centralized model obtain a patient's permission to have their records and information stored in a database. Physicians and other health care professionals can query the database for patient information and share it with others. A decentralized model allows for organizational control of data in which the physician stores patient information while permitting authorized personnel and entities access.
- What opportunities are there for physicians to provide feedback on HIE operations? Physicians should inquire about their ability to attend HIE meetings and to weigh in on the system's functionality.
- What information will be shared via the HIE? Some HIEs will share only lab data, while others will allow access to discharge summaries, notes, test results, and more.
The February issue of Texas Medicine will feature an in-depth report on HIEs in Texas. For answers to questions on HIEs or other health information technology (HIT) issues, contact TMA's HIT Department by calling (800) 880-5720 or by e-mailing HIT@texmed.org.
Action, Jan. 4, 2010