One of the greatest promises of health information technology and electronic health records is the ability to securely access and share patient information at the point of care. Currently, there are 8 health information exchanges (HIEs) in Texas funded with federal grants that can provide information about patients at the point of care.
It is difficult to watch as our beloved state suffers from the catastrophic effects of Hurricane Harvey. Even more difficult is the number of Texans displaced as they evacuate to safe places. This means many Texans are seeking medical care outside of their usual region or network of physicians. It helps to know that health information exchanges (HIE) are available to assist physicians by providing access to a patient’s information at the point of care.
Vital Connections: HIEs Improve Patient Care (Texas Medicine, Oct. 2012)
Texas HIEs - (HIEs funded by the ONC - does not include ALL Texas 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.
TMA Comment Letter to ONC Regarding the 2015 Federal Health IT Strategic Plan (Feb. 6, 2015)
TMA Comments to Texas Health Services Authority about the 2014 State HIE Plan (May 30, 2014)
TMA Letter to ONC RE: RFI -- Advancing Interoperability and Health Information Exchange (Apr. 22, 2013)
HIEs and the Gateway to Better Care (Texas Medicine, Apr. 2015)
Patients, Portals, and PHRs (E-Tips, Oct 11, 2013)
HIEs Ready to Sign Physician Practices (Action, July 1, 2013)
TMA Offers EHR Interoperability Tips (Action, May 1, 2013)
Health Information Exchanges Can Improve Patient Care (Texas Medicine, Feb. 2011)
Got HIE questions? Contact the HIT Helpline.