Health Information Exchange

  • How Do You Exchange Patient Data?

    One of the greatest benefits of health information technology (HIT) and electronic health records (EHR) is the ability to securely access and share patient information at the point of care.

    Ideally, all members of a health care team -- physicians, specialists, hospitals, labs – should be able to use HIT and EHRs to share patient information through a secure network, a process called interoperability. In fact, the Centers for Medicare and Medicaid Services (CMS) recently renamed the Medicaid Meaningful Use and MACRA’s Advancing Care Information (ACI) programs to Promoting Interoperability. Although there has been some progress toward interoperability, a lot of work remains.

    Use the resources below to find out how to get started.

  • Accomplishing HIE

    There are different ways HIE can be accomplished, and the needs and requirements vary by practice.

    While there are numerous ways to accomplish HIE, below are four types of HIE that are currently in use:

    • Direct is a technical standard for securely exchanging health information between health care entities such as physicians, specialists, hospitals and labs in a trusted network. Direct functions like regular e-mail but with HIPAA security measures in place that ensure the person receiving the message is the intended recipient. Direct sends specific information to a known source while HIEs find patient encounters and deliver associated records from known and unknown sources. Direct addresses are available from a variety of sources, including EHR vendors, public and private HIEs, as well as private service providers offering Direct exchange capabilities called Health Information Service Providers (HISPs).
    • Public health information exchanges (HIEs) can provide information about patients at the point of care. Some of the information includes lab results, medications, hospitalizations, and radiology reports. Each HIE is developing various services according to the needs of its users and the population served. Reach out to the HIEs to find out what services are offered and to learn details about participation and pricing. 
    • Private HIEs are typically operated by a hospital or health system which controls funding, governance and participation opportunities. The private HIEs offer similar patient information to public HIEs, but the data will likely be limited. If you are affiliated with a health system, inquire about HIE opportunities.
    • Health IT vendor interoperability can occur through organizations such as Commonwell Health Alliance and Carequality. These organizations are focused on providing the cross-vendor interoperability infrastructure that is patient-centered. Physicians that are interested in this option can ask their EHR vendor about their status of participation or membership in either of those organizations.
  • Texas Public HIEs

    Below are links to the public HIEs in Texas providing a variety of services.

  • Questions to ask HIEs

    Before committing to a local health information exchange (HIE), physicians need to ask questions. Physician health information technology experts recommend physicians consider the following:

    • What information will be shared via the HIE?
      Some HIEs will share only laboratory data, while others will allow access to discharge summaries, notes, test results, and more.

      How will physicians be able to determine the source, date, and time of the data?
      Answers to these questions will help physicians reconcile contradictory information they may encounter, such as a “penicillin allergy” for a patient pulled from one electronic medical record but “no known allergies” pulled from another.

      What privacy and security mechanisms does the HIE feature?
      Physicians should learn the HIE’s policies and procedures on how they’ll obtain patient consent for using the data. If a patient chooses to exclude some data from being shared, the physician should make sure the HIE discloses that fact.

      Does the HIE include the patient populations, referral networks, and the hospitals and other physicians the doctor works with?
      Make certain the HIEs connect to the local hospitals, labs, radiology services, and other facilities. Taking part in an HIE with limited connections could leave doctors having to make 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 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 initially, but physicians should ask whether potential future fees have been addressed.

      Who is on the HIE board of directors?
      HIE governance should represent health care stakeholders in the community.

      What are the computer system requirements to connect to the HIE?

      Does the HIE use a centralized or 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. In a decentralized model, the physician stores patient information and permits access by authorized personnel and entities.

      Are there opportunities 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.

  • HIE Advocacy Efforts

  • Hospitals Required to Send Admit, Discharge, Transfer Notices to Physicians

    Changes to Telemedicine  

    As of May 1, hospitals must electronically share their admit, discharge, and/or transfer (ADT) notices with the patient’s established primary care physician, group, or other practitioner identified by the patient. The requirement, a condition of participation under the Centers for Medicare & Medicaid Services’ Interoperability and Patient Access final rule, applies to all patients who receive emergency department (ED) or inpatient services, including at psychiatric hospitals.

    Find Out More  
  • Direct Messaging Can Help You Comply With Federal Information-Sharing Law

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    Direct messaging offers a secure, HIPAA-compliant method for sharing patient information – such as when sending or receiving referrals – and to receive timely notifications when a patient is admitted, discharged, or transferred to an emergency department.

    Find Out More About Direct  
  • Information Blocking Rule Compliance Now in Effect

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    Since April 5, all practices have been required to comply with the information-blocking regulations that are part of the federal 21st Century Cures Act, which is designed to facilitate widespread access and sharing of health information among patients and physicians.
    The rules require that physicians give patients prompt access to significant portions of the patient’s electronic health information (EHI) upon request, unless specific exceptions apply.

    Get More Information  
  • Medicaid Grant Could Pay for Your HIE Connection


    Have you or your practice been considering connecting your electronic health record (EHR) to a health information exchange (HIE), but keep getting hung up by the cost?

    Well, here’s some good news.

    Three public HIEs recently were awarded contracts for a Medicaid grant that could pay for you to connect to their exchanges.

    Get the Details  
  • TMA is helping to strengthen your practice by offering advice and creating a climate of medical success across the state.

  • What could a TMA membership mean for you, your practice, and your patients?