This paper will go into the history, need, challenges and where we are now with Health Information Exchange. What is a HIE?
A health information exchange (HIE) is a safe computer network that links the electronic health information systems of different health care providers, permitting those providers to share clinical and demographic data of patients they have in common. HIE provides the ability to electronically move health care information between various systems while maintaining the meaning of the information being exchanged. In other words HIE is technology at its best brings all the personal health information together and helps health providers make more informed decisions. The goal of health information exchange is to assist access to and retrieval of clinical data to provide safer, timelier, efficient, effective, equitable, patient-centered care. Health information exchange organizations (HIOs) provide the capability to electronically move clinical information between disparate health care information systems while maintaining the meaning of the information being exchanged.
The US history of HIE
In 1990, the Hartford Foundation gave out several grants to a variety of different cities and locales for the purposes of building what they called, “community health management information systems.” This was one of the first attempts at exchanging information about health electronically. Seven locations received these grants. The systems that were developed by the grantees were centralized data repositories that housed patient information including demographics, clinical data, and insurance eligibility information. The main purpose of the system, according to Vest and Gamm, was for assessment purposes and to make it easier to bill for patient care by having eligibility information verified right away- preventing the need for paperwork that’s typically exchanged when denial of payments occurs when someone was treated for something they were not covered for. None of these systems ultimately survived because in 1990, technology- including internet technology, were at a very prototypical stage. This was the first time also that someone attempted to integrate otherwise different health information- which as we have learned over the years is much easier said than done. Other major problems with the system included privacy concerns and in fact in some areas where these community health management information systems were created there was a real grass root effort mostly led by physicians that successfully lobbied the legislator in some states to do away with this health information exchange. And lastly because these were grant funded, there was a lot of problems for these systems to transition off grant funding support. In other words when the grant money ran out, it became very difficult to continue the operations of these systems because it was not clear exactly who should pay for it and what the return on investment is for someone who did. By the mid-1990s another form of HIE came onto the scene; this time in what was referred to as Community Health Information Networks or CHINs. Whereas the efforts in 1990, which were mostly collaborative endeavors by community stakeholders, CHINs were mainly commercial endeavors. These endeavors were primarily aimed at reducing costs by sharing data. There was an estimated 75 to several hundred CHINs established or at least planned, all of which, if not almost all of which, failed. According to Vest and Gamm the main reason for this failure was several fold; first there was a lack of a focus on community stakeholders which ultimately left at the table just a bunch of competitors which proved for a difficult model for success. In addition, vendors who were building these systems in the hopes of collecting fees seemed to pit the interests of hospitals against those of community physicians, which created some dismay. And finally, there was also no...
Please join StudyMode to read the full document