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Policymaking, Regulation, & Strategy

Accelerating Health Information Exchange (HIE)

The Department of Health and Human Services (HHS) is committed to transforming health care delivery into a system that is patient-centered and value-based. Existing Medicare and Medicaid programs and initiatives, as well as new programs authorized by the Patient Protection and Affordable Care Act (Affordable Care Act), focus on new service delivery and payment models that encourage and facilitate greater coordination of care and improved quality.

Critical to the success of these programs and the ultimate goal of a transformed health care system is real-time interoperable health information exchange (HIE) among a variety of health care stakeholders: clinicians, lab, hospital, pharmacy, health plans, payers and patient.  Greater access to patient-level health information is integral to improving the quality, efficiency, and safety of health care delivery.

HHS recognizes that the actual exchange of health information needs to be both interoperable and electronic across myriad information systems for us to realize a patient-centered, value-driven health care system.  

  • Interoperability is generally accepted to mean the ability of two or more systems or components to exchange information and use the information that has been exchanged.1 That means that there are two steps to interoperability: 1) the ability to exchange information; and 2) the ability to use the information that has been exchanged.  
  • Electronic HIE encompasses a broad array of strategies, technologies, types of exchange, and applications to share information. The use of HIE facilitates better communication and enables more coordinated and connected care across the full continuum of health delivery and payment settings.

To help drive this activity, HHS developed a Strategy and Principles to Accelerate HIE [PDF - 714 KB] informed by stakeholder input received through a Request for Information (RFI) [PDF - 233 KB]. The Strategy and Principles highlight HHS policy goals and ways HHS will further advance HIE beyond the current Medicare and Medicaid EHR Incentive Programs and ONC certification programs. These Principles and Strategies include:

  • New HHS regulations and guidance on existing programs will enable a patient’s health information to follow them wherever they access care with appropriate privacy and security safeguards.
  • HHS programs will advance HIE across providers including long-term and post-acute care, behavioral health, and laboratory providers.
  • HHS will advance multi-stakeholder development of standards, including an interoperability and certification road map that will serve as a transparent planning tool to guide standards development, adoption, and HIT certification.
  • HHS will build upon and move beyond the foundation of the Medicare and Medicaid EHR Incentive Programs and the ONC HIT Certification Program.
  • HHS will work to align HIT standards for quality measurement and improvement across Medicare and Medicaid.
  • HHS will implement policies that encourage electronic HIE incrementally and evolve from incentive and reward structures to electronic HIE as a standard business practice for providers.
  1. See IEEE Standard Computer Dictionary:  A Compilation of IEEE Standard Computer Glossaries (New York, NY: 1990).