The examples and perspective in this article deal primarily with the United States and do not represent a
worldwide view of the subject. (March 2014) |
Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region, community or hospital system. Participants in data exchange are called in the aggregate Health Information Networks (HIN). In practice, the term HIE may also refer to the health information organization (HIO) that facilitates the exchange.
The goal of HIE is to facilitate access to and retrieval of clinical data to provide to public health authorities in analyses of the health of the population.
Formal organizations support financial 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 Recovery and Reinvestment Act of 2009. [1] The 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 health information technology (HIT) are still being defined. Federal regulations and incentive programs such as "Meaningful Use", which is formally known as the EHR Incentive Program, [3] [4] are changing. The vast majority of HIEs and RHIOs remain tied to federal, state, or independent grant funding in order to remain operational. Some exceptions exist, such as the Indiana HIE. [5] [6]
In a centralized model of HIE, there is a central (or master) database that holds a copy of all of the records of every patient contained. In a federated model of HIE, there is no master database.
In a centralized model, patient information is uploaded to a single database from which any provider in the HIE can download. In a federated model, records are exchanged electronically among providers when they need them. [7] [8]
Exchanges in the US must operate with patient consent to comply with not only the Health Insurance Portability and Accountability Act (HIPAA) and also variety of state and federal laws and regulations. This was clarified by the Office of Civil Rights in the January 2013 Final Omnibus Rule Update to HIPAA. [9]
There are two methods for gaining patient consent. One is explicit consent and is termed opt-in. With this method, a patient is not automatically enrolled into the HIE by default and generally must submit a written request to join the exchange.
The other method is implicit patient consent and is termed opt-out. In this method, patients give implicit consent to join an HIE when they agree to use the services of a health care provider who is submitting data into an HIE and sign the provider's Notice Of Privacy Practices. Patients can request to opt out of the HIE, generally with a written form. [10]
Hospitals in the Dutch provinces Groningen, Friesland and Drenthe have created an (diagnostic) image exchange network in order to phase out CD/DVD based exchanges using an IHE (XDS) platform. St. Gerrit, the local HIE organization, has gradually expanded the network since 2014, spanning 10 hospitals to date.
This section needs additional citations for
verification. (September 2016) |
{{
cite web}}
: CS1 maint: bot: original URL status unknown (
link)
The examples and perspective in this article deal primarily with the United States and do not represent a
worldwide view of the subject. (March 2014) |
Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region, community or hospital system. Participants in data exchange are called in the aggregate Health Information Networks (HIN). In practice, the term HIE may also refer to the health information organization (HIO) that facilitates the exchange.
The goal of HIE is to facilitate access to and retrieval of clinical data to provide to public health authorities in analyses of the health of the population.
Formal organizations support financial 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 Recovery and Reinvestment Act of 2009. [1] The 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 health information technology (HIT) are still being defined. Federal regulations and incentive programs such as "Meaningful Use", which is formally known as the EHR Incentive Program, [3] [4] are changing. The vast majority of HIEs and RHIOs remain tied to federal, state, or independent grant funding in order to remain operational. Some exceptions exist, such as the Indiana HIE. [5] [6]
In a centralized model of HIE, there is a central (or master) database that holds a copy of all of the records of every patient contained. In a federated model of HIE, there is no master database.
In a centralized model, patient information is uploaded to a single database from which any provider in the HIE can download. In a federated model, records are exchanged electronically among providers when they need them. [7] [8]
Exchanges in the US must operate with patient consent to comply with not only the Health Insurance Portability and Accountability Act (HIPAA) and also variety of state and federal laws and regulations. This was clarified by the Office of Civil Rights in the January 2013 Final Omnibus Rule Update to HIPAA. [9]
There are two methods for gaining patient consent. One is explicit consent and is termed opt-in. With this method, a patient is not automatically enrolled into the HIE by default and generally must submit a written request to join the exchange.
The other method is implicit patient consent and is termed opt-out. In this method, patients give implicit consent to join an HIE when they agree to use the services of a health care provider who is submitting data into an HIE and sign the provider's Notice Of Privacy Practices. Patients can request to opt out of the HIE, generally with a written form. [10]
Hospitals in the Dutch provinces Groningen, Friesland and Drenthe have created an (diagnostic) image exchange network in order to phase out CD/DVD based exchanges using an IHE (XDS) platform. St. Gerrit, the local HIE organization, has gradually expanded the network since 2014, spanning 10 hospitals to date.
This section needs additional citations for
verification. (September 2016) |
{{
cite web}}
: CS1 maint: bot: original URL status unknown (
link)