Insufficiency in StandardsLack of standards in digital health information exchange can lead to some privacy concerns. Careers, Unable to load your collection due to an error. According to the current systematic review, studies with stricter designs reported more benefits from HIE. Blue Button includes a vision for better health and health care and a specific action consumers can takedownload your own health information and use it! For all studies in the final sample, we extracted information on the type of HIE investigated (community HIE, enterprise HIE, or vendor-mediated HIE). Electronic medical records (EMRs) are digital versions of the paper charts in clinician offices, clinics, and hospitals. Given the nature of how analyses are nested within articles in our dataset, we specified a regression model that examined the relationship between finding a beneficial effect and the aforementioned study characteristics while adjusting for clustering at the article level. Why is telehealth important for rural providers? Form Approved OMB# 0990-0379 Exp. Frequently Asked Questions | HealthIT.gov Differing strategies to meet information-sharing needs: publicly supported community health information exchanges versus health systems' enterprise health information exchanges. 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, and is commonly compared to sending a secured email. More complete and accurate information. For each analysis in each included study, we also extracted information on the nature of the relationship between HIE and the dependent variable studied. Int J Med Inform. In terms of settings, HIE research continues to be dominated by the emergency department setting. Identifying and correcting incorrect billing informationiv. Smith ML, Racoosin J, Wilkerson R, Ivey RM, Hawkley L, Holt-Lunstad J, Cudjoe TKM. NM conceptualized the study. Specifically, a large number of existing studies emanate from a small number of organizations in a limited number of states. To build or join an HIE for your own practice or hospital system, the National Rural Health Resource Center recommends performing the following readiness assessment: Identify and recruit the pertinent stakeholders in your practice or system, including the executive and management team, IT or applications director, and legal or compliance officer, as well as those outside your system.Identify your current privacy and security concerns and gaps in your current standards of care.Prioritize use cases for HIE within your system, develop appropriate benchmarks, and integrate these into your existing sustainability plan and operational assessments.Evaluate the current operational environment within the system and develop goals for implementing the HIE, including determining proper procedures and requirements for governance and onboarding new partners.Determine appropriate HIE workflows, and identify gaps in existing workflows that HIE can help to fill.Evaluate the current IT environment, including interface and interoperability gaps, and determine ways for HIE to fill it.Make the necessary assessments and adjustments for Stage 1 and 2 meaningful use adoption and attestation.Determine the cost and return-on-investment related to each use case, and use that to develop an appropriate financial sustainability model and implementation timeline for incorporating HIE into your practice or system. The purpose of the current study is to review the recent literature on the impact of HIE. Please enable it to take advantage of the complete set of features! Secondary health care provider benefits include reduced expenses associated with: the manual printing, scanning and faxing of documents, including paper and ink costs, as well as the maintenance of associated office machinery HIE helps facilitate coordinated patient care, reduce duplicative treatments and avoid costly mistakes. What are the differences among electronic medical records, electronic health records, and personal health records? Murphy SM, Howell D, McPherson S, Grohs R, Roll J, Neven D. A randomized controlled trial of a citywide emergency department care-coordination program to reduce prescription opioid-related visits: an economic evaluation, A population ecology perspective on the functioning and future of health information organizations, Approaches to patient health information exchange and their impact on emergency medicine. Date 9/30/2023, U.S. Department of Health and Human Services. Health information exchange use (1990-2015): a systematic review. eGEMs 5.1 (2017).2.Vest, Joshua R., and Larry D. Gamm. This information can be brought into a patient's chart as electronic . Health Information Exchanges - Atlantic Coast Rehabilitation EMRs contain notes and information collected by and for the clinicians in that office, clinic, or hospital and are mostly used by providers for diagnosis and treatment. Electronic health information systems can help prevent errors by ensuring that everyone involved in a patients carewhether in a primary care setting, a specialists office or emergency departmenthas access to the same information. Whereas the majority of analyses used cohort designs, there were 13 analyses, contained within 7 studies, which used more rigorous randomized-controlled trials or quasi-experiments. Overall, our systematic review of the literature found that high quality evidence exists to link HIE with a reduction in healthcare utilization and costs. Health information exchange helps doctors, nurses, patients, pharmacists, and others to seamlessly exchange vital medical information electronically with better quality, speed, security, and cost. When in control of their own health information, patients can actively participate in their care coordination by: i. Increasingly, they can also plug it into apps and tools that help them to better understand their health, prevent illness, and modify their own behaviors in healthy ways. World Health Organization [PDF - 3.38 MB], Centers for Medicare & Medicaid Services, American Health Information Management Association. PubMed and Scopus databases were used to identify empirical articles that evaluated HIE in the context of a health care outcome. Epub 2015 Dec 11. Community HIEs attempt to facilitate information exchange among the widest set of available providers within an area. Certainly, the electronic exchange of health information cannot completely replace communications between patient and provider. Bethesda, MD 20894, Web Policies Recently, New York State made HIE participation a requirement for hospitals and urgent care providers.42 Therefore, it is unclear if HIE efforts in states with less concerted efforts to support health information technology and quality improvement, will experience similar benefits. Interoperability among hospitals treating populations that have been marginalized. Below are some of the common challenges associated with HIE. Jackson CT, Trygstad TK, DeWalt DA, DuBard CA. Eliminates redundant or unnecessary testingv. FOIA Studies assessing a community HIE were more likely to report a benefit effect compared to studies that examined other types of HIEs (70.3% vs 54.2%, P=.04). In contrast, enterprise HIE or vendor-mediated HIEs have narrower exchange networks and, therefore, may not have access to the range of patient information necessary to address the challenges that result in poor outcomes.38 At the same time, it is possible that the observed differences in benefits by HIE type is confounded by technology maturation, given that enterprise and vendor-mediated HIEs tend to be newer than community HIEs. official website and that any information you provide is encrypted 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. The Office of the National Coordinator for Health Information Technology (ONC). Can a health information exchange save healthcare costs? Evolution of Health Information Sharing Between Health Care Organizations: Potential of Nonfungible Tokens. The keyword search identified 1103 articles which we reviewed through the process shown in Supplementary Appendix S2. These benefits include reduced duplicate procedures, lower . Identifying and correcting wrong or missing health informationiii. The subsequent sections provide detailed information and example scenarios for each of the three forms. National Library of Medicine We present a synthesis of these 7 studies in Table 3. Such benefits include fewer duplicated procedures, reduced imaging, lower costs, and improved patient safety. Non-economic benefits of the HIE (in-direct return on investment) Risks and liabilities involved with joining the HIE 2 Talk with your vendor Some vendors have incorporated the functionality of electronic health information exchange into their Electronic Health Record (EHR). The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules are the main Federal laws that protect health information. The foundation of standards, policies and technology required to initiate all three forms of health information exchange are complete, tested, and available today. This resulted in a sample of 51 studies (27 from previous review + 24 in the current review) consisting of 157 analyses (94 from previous review + 63 newly identified). Critical to this transformation is timely interoperable Health Information Exchange (HIE) among a variety of health care stakeholders (clinicians, laboratories, hospital, pharmacy, health plans, payers and patients). See the following web page for further information: Content last reviewed on September 21, 2017, Official Website of The Office of the National Coordinator for Health Information Technology (ONC). Comput Methods Programs Biomed. Study after study shows that engaged patients recover more quickly, and stay healthy longer. Genes (Basel). The remaining analyses reported no effect. For every article that was included, we extracted various information including type of study design used (cohort study, cross-sectional study, randomized controlled trial, quasi-experimental study), setting and population studied (primary care physicians, hospital, emergency department), and country of origin. We hope that organizations will continue to build on and evolve the technical capability they have available for patients. Medical staff immediately know about your allergies, health problems, medications, and prior visits, helping them care for you without delay. Epub 2023 May 23. Lastly, we seek to determine the extent to which newly published studies have improved on the methodological shortcomings of earlier studies, by utilizing stronger research designs, focusing on a broader set of outcome measures, and/or examining more diverse populations and/or settings. HIE helps facilitate coordinated patient care, reduce duplicative treatments and avoid costly mistakes. Contains Only Summary DocumentSome health information exchange only contains a summary document, that can also be referred to as continuity of care document. Patient data contained in an HIE can include the following: Past medical historyCurrent medicationsLaboratory orders and resultsUp to date progress notesPatient referralsDischarge summaries. 1.2 Executive Summary. and transmitted securely. The Security Rule sets rules for how your health information must be kept secure with administrative, technical, and physical safeguards. Supplementary material is available at Journal of the American Medical Informatics Association online. Report to Congress on Health Information Blocking. Importantly, we found that studies that evaluated community HIEs were significantly more likely to find benefits than studies that focused on other types of HIEs. the time and effort involved in recovering missing patient information, including any duplicate tests required to recover such information. Finally, we combined the information on the newly identified studies in the current systematic review with the studies identified in the previous systematic review by Rahurkar et al. Health Information Exchanges - Aspen Hills Healthcare This enabled us to examine whether HIE type was related to the likelihood of finding a beneficial relationship across all 51 studies. Wont you join us? Improve patient safety by reducing medication and medical errors; Increase efficiency by eliminating unnecessary paperwork and handling; Provide caregivers with clinical decision support tools for more effective care and treatment; Eliminate redundant or unnecessary testing; Improve public health reporting and monitoring; Engage healthcare consumers regarding their own personal health information; Improve healthcare quality and outcomes; and, Healthcare Information and Management Systems Society (. Does participation in health information exchange improve hospital efficiency? As more organizations adopted the Blue Button and more patients used it, it became apparent that there was a need for more and more complex ways of downloading and transmitting data. See the following resources for more information: With electronic prescribing, or e-Prescribing, health care providers can enter prescription information into a computer device like a tablet, laptop, or desktop computer and securely transmit the prescription to pharmacies using a special software program and connectivity to a transmission network. Vest JR, Kern LM, Silver MD, Kaushal R, investigators H. The potential for community-based health information exchange systems to reduce hospital readmissions, Impact of a health information exchange on resource use and Medicare-allowable reimbursements at 11 emergency departments in a midsized city, Use patterns of health information exchange systems and admission decisions: reductionistic and configurational approaches, Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations. The https:// ensures that you are connecting to the Owing to the generic nature of the document, it sometimes misses important information on the patients health that may be important to provide the correct treatment. References:1.Devine, Emily Beth, et al. We included only empirical peer-reviewed articles and thus excluded policy briefs, letters to the editor, governmental reports, commentaries, and other nonpeer-reviewed manuscripts. To better track and securely share patients complete medical histories, more and more health care providers are participating in health information exchange (HIE). We also found that studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise . The Privacy Rule gives you rights with respect to your health information. We identified 24 articles for inclusion that were published between May 2014 and June 2017. Bookshelf Health care providers are increasingly sharing clinical data with other providers who care for the same patient by using electronic health information exchange(HIE). We judged the mechanism of HIE as Push if patient information from HIE was automatically provided without the clinician taking action. Health information exchanges--Unfulfilled promise as a data source for clinical research. HIE reduces the amount of time patients spend filling out paperwork and briefing their providers on their medical history, allowing more time for discussions about health concerns and treatments. J Gen Intern Med. This form of information exchange enables coordinated care, benefitting both providers and patients. What are the benefits of health information exchange? Effects of Health Information Exchanges in the Adult Inpatient Setting: a Systematic Review. These include health information exchange (HIE), the Nationwide Health Information Network (NHIN), and at one time, community health information network (CHIN). Federal government websites often end in .gov or .mil. Reduced repeat imaging was significantly related to annual savings of $32460, HIE usage was related to reduction lower odds of readmission. What are the benefits of health information exchange? Question 1: HIE benefits include: (choose one) 1)Reducing The joint Health Information Exchange (HIE), formerly VLER HIE, securely connects health and benefit information systems from Department of Defense (DOD), Department of Veterans Affairs (VA) and other federal and private sector partners. Two of these studies focused on the emergency settings,30,37 2 studies examined outpatient settings,17,24 and 1 study each examine the inpatient,32 community,27 and HIV care setting,35 respectively. 8600 Rockville Pike Benefits of Health Information Exchange. Previous reviews have found little rigorous evidence that HIE positively affects these anticipated benefits. Stockwell MS, Natarajan K, Ramakrishnan R et al.. Immunization data exchange with electronic health records, Completeness and timeliness of notifiable disease reporting: a comparison of laboratory and provider reports submitted to a large county health department. Health Information Exchange | HealthIT.gov Bivariate Relationships Between Various Study Characteristics and Finding a Beneficial Effect from HIE on the Outcome Studied (n=24 articles that include n=63 analyses). The preponderance of articles stemming from New York is likely due to the states substantial public and private investments aimed at fostering interoperable health information technology adoption along with the commitment to evaluate this state-level policy intervention.41 In addition to state funding, several communitys served by HIEs in New York have qualities that favor HIE impact studies, including very large numbers of events, highly fragmented patient care patterns between emergency departments, and histories of innovative health care quality improvement. The evidence in support of the identified relationship was considered high-quality if the study used a design that had strong internal validity, which included randomized controlled trials or quasi-experimental approaches. We also found that studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise HIEs or vendor-mediated exchanges. Question: HIE benefits include: Reducing duplicative treatments and avoid costly mistakes A barrier between health-related research and actual practice A national standard for technical infrastructure for leverage by national and State-level initiatives. EHRs also share information with other health care providers, such as laboratories and specialists. We found that HIEs operating in the state of New York are currently the most frequently studied. The Health Resources Services Administration defines telehealth as the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. the physical mailing of patient charts and records, and phone communication to verify delivery of traditional communications, referrals, and test resultsiii. This site needs JavaScript to work properly. The Button has become a recognized brand that signifies consumer access to and use of electronic health data. The findings of our analysis will be beneficial to stakeholders interested in how HIE affects care; and to what degree the promised benefits of HIE are being realized.13. Public Health and Disease Surveillance . National Library of Medicine Building on the gaps in literature that were identified in the prior systematic review, we extracted information, when possible, on whether or not a study measured actual usage of HIE in clinical care (Yes/No), the mechanism by which HIE information is accessed (Push/Pull), and the process by which patients consent to include their data in the HIE (Opt-in/Opt-out). Careers. . The .gov means its official. Similar to the previous study, we identified articles by searching for HIE-related and healthcare outcome related search terms together (See Supplementary materials, Appendix S1). Inclusion in an NLM database does not imply endorsement of, or agreement with, Directed Exchange ability to send and receive secure information electronically between care providers to support coordinated care. Previous reviews have found little rigorous evidence that HIE positively affects these anticipated benefits. HIE Quality Check. HIE Benefits | HealthIT.gov Health information exchange (HIE)-Definition, classification, benefits
