Health Information Exchange

Health information exchange (HIE) is the mobilization of healthcare information electronically across organizations within a region, community or hospital system.

HIE provides the capability to electronically move clinical information among disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer and more timely, efficient, effective, and equitable patient-centered care. HIE is also useful to public health authorities to assist in analyses of the health of the population.

HIE systems facilitate the efforts of physicians and clinicians to meet high standards of patient care through electronic participation in a patient's continuity of care with multiple providers. Secondary health care provider benefits include reduced expenses associated with:

• the manual printing, scanning and faxing of documents, including paper and ink costs, as well as the maintenance of associated office machinery
• the physical mailing of patient charts and records, and phone communication to verify delivery of traditional communications, referrals, and test results
• the time and effort involved in recovering missing patient information, including any duplicate tests required to recover such information

According to an internal study at Sushoo Health Information Exchange, the current method of exchanging patients' health information accounts for approximately $17,160 of expenses annually for a single-clinician practice.

Formal organizations are now emerging to provide both form and function for health information exchange efforts, both on independent and governmental/regional levels. These organizations are, in many cases, enabled and supported financially by statewide health information exchange grants from the Office of the National Coordinator for Health Information Technology. These grants were legislated into the HITECH components of the American Reinvestment and Recovery Act in 2009. The latter organizations (often called Regional Health Information Organizations, or RHIOs) are ordinarily geographically defined entities which develop and manage a set of contractual conventions and terms, arrange for the means of electronic exchange of information, and develop and maintain HIE standards.

In the United States, federal and state regulations regarding HIEs and HIT (health information technology) are still being defined. Federal regulations such as "Meaningful Use" legislation as well as the implementation of some state governments of state-sponsored HIEs (such as the North Carolina HIE) in addition to fluctuating health care regulations among the states are rapidly changing the face of this relatively new industry. HIEs and RHIOs continue to struggle to achieve self-sustainability and the vast majority remain tied to Federal, State, or Independent grant funding in order to remain operational; with some exceptions such as the Indiana HIE.