Health information exchange (HIE) is defined as 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, more timely, efficient, effective, 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 physicians and clinicians meeting 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: duplicate tests, time involved in recovering missing patient information, paper, ink and associated office machinery, manual printing, scanning and faxing of documents, the physical mailing of entire patient charts, and manual phone communication to verify delivery of traditional communications, referrals and test results. According to an internal study at Sushoo Health Information Exchange, a single-clinician practice spends $17,160/year associated with the current method of exchanging patients' health information.
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.[1] 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.[2]
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[3] as well as the implementation of some state governments of state-sponsored HIEs (such as the North Carolina HIE[4]) 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.[5]
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Chesapeake Regional Information System for our Patients (CRISP) is a non-profit corporation that is implementing health information exchange in the state of Maryland. The organization also serves as the Health IT Extension Center for Maryland. CRISP was created by Johns Hopkins Medicine, MedStar Health, the University of Maryland Medical System and Erickson Retirement Communities.[6] Audacious Inquiry serves as program director and technical architect for the health information exchange while Dynamed Solutions provides project management and organizational support under CRISP.
NoVA RHIO serves as the health information exchange organization for northern Virginia. The NOVA RHIO organization recently began a pilot to ensure that electonic copies of patient medication histories are available from Pharmacies in the region's emergency departments.[7]
e-Health Network of Long Island is a non-profit RHIO servicing eastern Nassau county and all of Suffolk County in Long Island, New York. Members of the EHNLI include Stony Brook University Medical Center, Winthrop-University Hospital, Southampton Hospital, and other various hospitals, adult long-term care facilities, and community physicians. HealthUnity is the primary technology provider. EHNLI's headquarters are located in Stony Brook, NY.
STHL is a non-profit New York RHIO designed as a partnership which brings together health care providers and consumers in Central New York with technology that will improve health care quality, access, and safety while reducing costs.
Sushoo is an independent HIE operating on the community level in multiple states.
The OpenHRE Community is a consortium of communities and organizations throughout the United States that are working together to achieve secure and sustainable health information exchange via utilization of the OpenHRE Toolkit, an open source software suite originally developed by Browsersoft, Inc. OpenHRE was used to deploy the Nation's first Multiple Health Market Health Information Exchange between Indianapolis, Boston and Mendocino CA.
Health Monitoring Systems is a private firm that connects hundreds of hospitals to public health departments throughout the United States primarily for the sake of syndromic surveillance. Public health and hospital users are able to see regional emergency department activity.
An independent, not-for-profit corporation established to develop a Regional Health Information Organization (RHIO) for Nassau county in Long Island, NY. Headquartered in Manhasset, NY.
A health care consortium and OpenHRE Community Contributor serving the medically uninsured in Bexar County, TX. HASA participants include the seven major safety net hospitals, City of San Antonio Metropolitan Health District (Immunization Data) and a network of community FQHCs serving the uninsured of San Antonio. The SecureShare centralized community repository contains demographic and clinical records for over 500,000 uninsured patients.
CareSpark is an innovative effort underway in the central Appalachian region that is working to improve health through the collaborative use of health information. The CareSpark region includes 17 counties in the Tri-Cities Tennessee and Virginia area with approximately 750,000 residents, 21 hospitals, and 1,200 physicians.
A rural community based 501.c3 not-for-profit corporation and OpenHRE Contributor in Southern California. EKCITA has enabled sharing of electronic health files and clinical data for public health, patient care, and research purposes. The EKCITA deployment provides community caregivers access to over 32,000 local patient health profiles.
A non-profit, rural health network and OpenHRE Contributor comprising community health centers, local and regional hospitals and FQHCs, a social service agency, a tribal health clinic, a regional State of Louisiana Office of Public Health, and a coalition of over seventy St. Mary Parish organizations. The ByNet centralized repository contains demographic and clinical records that will exceed 100,000 patients.
The Kansas Diabetes Quality of Care Project involves over 68 funded organizations at 90 provider sites across the State of Kansas. This effort has electronically connected many of these sites to allow the collection and analysis of patient diabetes data by KDHE personnel for improving quality of care. Over 350 health professionals participate in this program with representation from over 50% of Kansas’ counties. KDHE is an OpenHRE Contributor.
The BBRHIO is a 501.c3 not for profit Florida Corporation that aims to deliver an enhanced level of patient centered care. Headquartered in Tallahassee, Florida.
Southwest Ohio, North Central Kentucky and South Eastern Indiana Regions.
The Indiana Health Information Exchange (IHIE) provides several health information exchange services throughout the state of Indiana. IHIE provides a clinical messaging result delivery service and a clinical quality improvement services called Quality Health First(tm)
Massachusetts SHARE (Simplifying Healthcare Among Regional Entities) is a regional collaborative initiative operated by the Massachusetts Health Data Consortium. In June, 2009, MA-SHARE merged with the New England Healthcare Exchange Network.
NEHEN, headquartered in Waltham, MA is a 501.c3 organization with more than thirty five member organizations and founded in 1998. Initially focused on payor/provider information exchange, after the merger with MA-SHARE, NEHEN now offers electronic prescribing support and clinical information exchange to its members as well as healthcare administrative transaction support.
Redwood MedNet, located in Mendocino County, California, is a community based nonprofit 501(c)(3) organization operating a clinical results delivery service in a thinly populated 5,000-square-mile (13,000 km2) rural region on the north Pacific coast.
The MidSouth eHealth Alliance is a community wide information system that helps health care providers in the treatment of patients. Providers are as doctors, nurses, healthcare workers, hospitals, and clinics. The MidSouth eHealth Alliance is based in Memphis, TN.
The Michiana Health Information Network is a health information exchange that support institutions and health care providers and clinicians in northern Indiana and southwestern Michigan.
UPMC is an integrated healthcare delivery network that provides healthcare services to a large portion of the population in Western Pennsylvania. Incorporating an HIE solution has enabled the integration of patient data across the enterprise in addition to the flexibility of the creation and rapid deployment of enterprise wide applications that leverage integrated patient data.
Covering more than half of Israel’s population, this HIE has been operational since 2001. The HIE includes 16 hospitals (8100+ beds), 1300 primary and specialized clinics and 400 pharmacies, and collectively provides health services to close to over 5 million patients.
WHIN - Western Health Information Network (formerly Long Beach Network for Health) Is an independent, community based not-for-profit corporation operating a regional Health Information Exchange for Southern California. Headquartered in Long Beach, CA.
MedVirginia Solution® is an HIE serving central Virginia.
The U.S. Department of Veteran's Affairs and the Department of Defense have several very large health information exchange projects including FHIE, BHIE, CHDR, and VLER.