Government's Role in Health Information Exchanges

Instructor: Maya Shapland

Maya has worked in the clinical, education, and management sections of healthcare for over 25 years and holds bachelor's degree in Speech and associate degree in Nursing.

In this lesson, you'll see an overview of the government's role in health information exchange, the laws that protect information involved, as well as, the responsibilities of the regional information organizations.

Health Information Exchange

Carolyn is at the helm of her medical practice with 15 medical providers, each with their own specialty. Keeping track of the patients' health information and coordinating their care is a huge responsibility. Healthcare technology is coming to the rescue with the Health Information Exchange (HIE). Carolyn is developing the organizational policies of this electronic network which allows sharing of important patient information from the patient's providers that can improve patient safety and quality of care by getting the information to those delivering the care.

Government HIE Oversight

Carolyn will use the resources available to her for the development of her HIE team. The Office of the National Coordinator for Health IT (ONC) has oversight and information for those addressing HIE in their facilities. The states have embraced the State Health Information Exchange Cooperative Agreement Program for the development of HIE. Medicaid and Medicare are also encouraging adoption of HIE and have provided financial incentives for doing so.

Examples of HIE impact at Carolyn's facility can be seen in the following:

  • Ability to find patient information, test results, provider's progress notes, and ancillary provider documentation of care, and payer information
  • Increases patient safety and quality by having patient data immediately available for the treatment plan, prevent medication and diagnostic errors.
  • Allows communication between providers and staff to increase efficiency in the workflow such as prescriptions given, refills, and orders for treatments without duplication.
  • Reduces readmissions by increased monitoring of high-risk patients.

Health Information Exchange

There are many software programs that communicate with one another making HIE more readily available. There are three types of exchanges:

Types of Exchange Characteristics
Patient and provider exchange Health information sharing between patients & providers including correcting mistakes
Provider request for patient information Providers can request information on patients they are seeing such as medication lists or problem lists
Direct provider to provider-payor and government disease surveillance Sharing immunization status with health department

Regional Health Information Organizations

Many organizations are coming together in a particular region say, all the facilities in Western North Carolina, to share patient health information electronically with oversight to promote a safe and secure network. This is called a Regional Health Information Organization (RHIO). The issues surrounding the RHIO revolve around the security of protected health information which is mandated by the law known as Health Insurance Portability and Accountability Act (HIPPA) and the Healthcare Information Technology for Economic and Clinical Health (HITECH) Act. RHIO's must provide security and safeguards for all staff working within the electronic medical record (EHR) and provide a private and secure healthcare information exchange.

Responsibilities of RHIO

Carolyn is developing the security policies that are in line with the regulations overseeing health information technology. This includes training for all staff, providers and leadership, ensuring all technology including hand-held devices are correctly evaluated for a secure connection and network access remains safe.

Oversight of a regional network requires the ability for the software pieces to communicate with one another when required. Information technology and vendors can assist Carolyn in this process. Making sure provider A can access patient data when needed and share with provider B is crucial to the success of HIE.

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