Health Information Exchange: It Should Just Work

The day is not far off when any hospital discharging a patient or doctor making a referral will be able to send along needed information seamlessly, electronically, and easily from their electronic health record (EHR) to the next point of care and to patients. This means safer, better and cheaper care.

ONC believes progress toward this goal will be clear and rapid, powered by:

  • Meaningful Use requirements
  • Rapid development of health information exchange services by State HIE grantees, regional networks and EHR vendors
  • New payment models urgently requiring better care coordination and patient engagement tools

It’s tremendously exciting that the requisite standards building blocks—a single national standard for a care summary that can be shared at transitions and transport standards to send and receive information—are available, are in use, and have been included in the proposed Stage 2 standards and certification rule.

But there’s a lot more we need to do to make health information exchange “just work” from the standpoint of clinicians, vendors, and patients. Over the next few months, we will focus on a few key initiatives that aim to lower the cost, complexity, and difficulty of exchange so that information really can follow patients wherever and whenever they seek care.

Increasing Trust through Common Policies

ONC has recently released guidance Exit Disclaimer defining common policies, standards, and implementation approaches (including on issues like issuing digital certificates and identity proofing end-users) for the more than 40 states launching DIRECT services. This guidance will give providers and other stakeholders confidence that DIRECT is being implemented according to technical specifications and with appropriate policies to support widespread exchange, trust, and interoperability.

Making Referrals Easy for Providers

Providers face at least two challenges when it comes to sending patient referral information easily and electronically. They often need to leave their EHR workflow to access health information exchange services and can’t exchange information with providers using different health IT products or platforms. ONC’s 360X Project Exit Disclaimer aims to address both issues through a community-led initiative to support “closed loop referrals” among health care providers. The goal is straightforward but bold: Providers should be able to send referrals from their EHR workflow to providers in unaffiliated organizations, using different EHRs and supported by different health information exchange services. Community participants will develop common implementation guidance and launch pilots by the end of the year. We invite you to participate in this exciting effort, joining many of the nation’s leading health IT vendors Exit Disclaimer.

Getting Lab Results Moving to Providers

Five states and one territory in the State HIE community—West Virginia, Florida, Alaska, Hawaii, North Carolina, and Guam—kicked-off an exciting initiative to jump start electronic lab result reporting using DIRECT, relying on guidance Exit Disclaimer recently released by ONC. At our summit in May, grantees and their pilot partners put their heads together with industry experts to develop solutions that can be replicated across the nation. While many providers already receive lab results electronically and in structured form from their labs, this effort gives labs and providers, and especially those with fewer resources and capacity, another option for lab results delivery. Having structured lab results in EHRs supports chronic care improvement, quality measurement, and prompt and accurate diagnosis.

As we’ve said before, we expect health information exchange to turn the corner in 2012. We’ve got the standards building blocks. There is an urgent need to improve care coordination. Information exchange services are developing rapidly in the market. But we also have to make sure health information exchange “just works” for providers, vendors, and patients. We think that’s a pretty important focus for this year. Please join us in making it happen.

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2 Comments

  1. John Lynn says:

    Great discussion. I started a similar discussion in this post about the need for broader EHR adoption in order to facilitate HIE: http://www.emrandhipaa.com/emr-and-hipaa/2012/07/18/is-lack-of-ehr-the-real-hie-problem/ The comments in that post are also very revealing and insightful about the challenges of HIE.

  2. dav says:

    Health information exchange participants are increasingly facing concerns regarding arrangements under which their business associates or health information exchange participants store, process or otherwise handle or use protected health information (“PHI”) outside the United States and its territories (commonly referred to as “Offshore Activities”). Are policies and procedures in place to ensure that PHI and other personal information remain secure?

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