Physicians and Health Information Exchange (HIE)

What is HIE?Physicians and Health Information Exchange (HIE)

What is HIE?

© eHealth Initiative & Foundation, 20062

Today’s Reality…

Have you ever had an afternoon like this?• Patient waiting in the room for follow up of

emergency room visit• Records not yet received

How long does patient wait? How long do you wait?What assumptions do you not want to make…

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Today’s Reality…• Data is stored in silos, across multiple stakeholder groups• Clinical research and public health is hindered by paper-based,

fragmented systems – costly and slow processes• Data is required from multiple sources to have timely, and effective

clinical decision support• Public health agencies forced to utilize phone, fax and mail to

conduct public health surveillance, detection, management and response

• Physicians spend 20 - 30% of their time searching for information…10 - 81% of the time, physicians don’t find the information they need in the patient record

© eHealth Initiative & Foundation, 20064

Why Health Information Exchange…

Health information exchange (HIE):• the mobilization of healthcare information electronically within a region or community.  •facilitate access to and retrieval of clinical data across organizations to provide safer, more timely, efficient, effective, equitable, patient-centered care.

© eHealth Initiative & Foundation, 20065

‘HIT’ from ‘HIE’…Is There a Difference?

Health Information Technology (HIT) Local deployments of technology to

support organizational business and clinical requirements

Health Information Exchange (HIE) Infrastructure to enable data sharing

between organizations

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Example of Health Information Technology (HIT)

• Electronic Medical Record (EMR)• Management Information System (MIS)• Laboratory Information System (LIS)• Computerized Physician Order Entry (CPOE)• E-prescribing and order-entry only with (eRx)• Personal Health Records (PHR)

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Public Interest in Health Information

Consumer Experience with Patient Safety and Quality Information Percentage who say...

0 10 20 30 40 50 60 70 80

The coordination among the different healthprofessionals that they see is a problem

They have seen a health care professional and noticedthat they did not have all of their medical information

They had to wait or come back for anotherappointment because the provider did not have all

their medical information

Source: Kaiser Family Foundation/AHRQ/Harvard School of Public Heallth National Survey on Consumer's Experiences with Patient Safety and Qualtiy Information , November 2004

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HIE: Opportunities to Consider• Order tests, medications, referrals• Receive results (labs, imaging, dispensing records)• Get paid (claims, claims attachments)• Query (patient eligibility, allergies, diagnoses, meds, labs, other providers,

immunizations)• Send/receive a message/document (d/c summaries, consultation results)• Emergency alerting and situational awareness (PH alerts, system status e.g. ER

saturation)• Patient record access/communication (patient portal, e-visits, reminder/recall)• Decision support (powered by ALL meds, allergies, etc.)• Accountability (quality-safety-cost scorecards)• Surveillance (outbreaks, underserved, disease trends)• Collaborate (shared case management tools)

© eHealth Initiative & Foundation, 20069

Today’s Health Information Exchange Initiatives: What Are They Doing?

Primary focus continues to be building systems to support sharing of clinical information

DATA CURRENTLY BEING SHARED ELECTRONICALLY2006 SURVEY RESULTS

15%

26%22% 23% 26%

13%

22%26%

21% 22%18%

13% 11% 13% 12%

20%

9%

0%5%

10%15%20%25%30%

© eHealth Initiative & Foundation, 200610

Focus on Disease Management, Quality Reporting, and Population Health

Advancements in functionality to support improvements in quality and safety are evident. Traditional uses to support care delivery, a number are now expanding functionality

Data Exchange Functionalities in 2006

26%25% 24% 23%

20% 20%

14% 14% 13%

0%

5%

10%

15%

20%

25%

30%

Clinical

documentation

Results deliv ery Consultation/referral Electronic referral

processing

Alerts to prov iders Disease/chronic

care management

Prov ide quality

performance

reporting to

clinicians

Prov ide public

health electronic lab

reporting

Prov ide

disease/chronic

care management

© eHealth Initiative & Foundation, 200611

Physicians and Health Information Exchange: Tips for Success

• Trust and transparency Neutral entity that brings together multiple stakeholders

• Physician Champions needed• Incremental steps towards a long-term vision and strategy• Select HIE functions that make a clinical difference and improve

outcomes• Point of care and work flow

Accessible and integrated into routines to provide value• Data must be current and reliable• Ensure privacy and integrity of data

© eHealth Initiative & Foundation, 200612

Engaging Physicians in Health Information Exchange

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