About Health Information Exchange
Electronic health information exchange (HIE) allows doctors, nurses, public health professionals, pharmacists, other healthcare providers, and patients to appropriately access and securely share a patient’s vital medical information electronically—improving the speed, quality, safety, and cost of patient care.
What Is Health Information Exchange?
With the widespread adoption of secure electronic data transfer, most Americans’ medical information is now stored electronically rather than on paper. When medical information is shared between providers, it often happens through electronic health information exchange, which can greatly improve the completeness of a patient’s records. This includes past history, current medications, and other vital information, all of which are reviewed during visits.
Appropriate, timely sharing of vital patient information can help to put patients in charge of their own care, better inform decision-making at the point of care, and allow providers to:
- Avoid readmissions
- Avoid medication errors
- Improve diagnoses
- Decrease duplicate testing
Even if a practice has successfully incorporated faxing patient information into their workflow, transitioning to electronic health information exchange offers significant benefits. The value of electronic exchange lies in the speed of exchange as well as the standardization of data. Once standardized, the data can seamlessly integrate into the recipient’s’ electronic health record (EHR), further improving patient care.
There are two primary forms of exchange that can be used for a variety of care purposes:
TEFCA’s Permitted Reasons for Health Information Exchange
The Trusted Exchange Framework and Common Agreement helps to define the acceptable reasons to share patient health data, as well as the parameters under which this data can be shared. Health information exchange is permitted for the following exchange purposes:
- Treatment
- Payment
- Healthcare Operations
- Public Health
- Government Benefits Determination
- Individual Access Services (patient or caregiver access to records)
Types of Health Information Exchange
- Directed Exchange – ability to send patient information—such as laboratory orders and results, patient referrals, or discharge summaries—directly to another care professional
- Query-Based Exchange – ability to find and/or request information on a patient from other providers, often used for unplanned care
The foundation of standards, policies and technology required to initiate both forms of health information exchange are complete, tested, and available today. The subsequent sections provide detailed information and example scenarios for each of the three forms.
Learn more about ONC standards, policies and technology.
Directed Exchange (Push)
Directed exchange, sometimes referred to as push exchange, is used by providers to easily and securely send patient information—such as laboratory orders and results, patient referrals, or discharge summaries—directly to another health care professional. This information is sent over the internet in an encrypted, secure, and reliable way amongst health care professionals who already know and trust each other. This form of information exchange enables coordinated care, benefitting both providers and patients. For example:
- A primary care provider can directly send electronic care summaries that include medications, problems, and lab results to a specialist when referring their patients. This information helps to inform the visit and prevents the duplication of tests, redundant collection of information from the patient, wasted visits, and medication errors.
Directed exchange is also being used for sending immunization data to public health organizations or to report quality measures to the Centers for Medicare & Medicaid Services (CMS).
Query-Based Exchange (Pull)
Query-based exchange is used by providers to search and discover accessible clinical sources on a patient. For example:
- Emergency room physicians who utilize query-based exchange to access patient information—such as medications, recent radiology images, and problem lists—to adjust treatment plans to avoid adverse medication reactions or duplicative testing.
- If a pregnant patient goes to the hospital, query-based exchange can assist a provider in obtaining her pregnancy care record, allowing them to make safer decisions about the care of the patient and her unborn baby.