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HIEs help you share data, cut costs, improve patient care
e-Reports, Jan. 7, 2013
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You may be missing opportunities that can help you improve patient care and reduce health care costs if you are not participating in a health information exchange (HIE). An HIE allows you to securely store and transmit data electronically to another physician office, hospital or lab using an electronic health records (EHR) system.

Hurricane Sandy demonstrated how New York’s statewide HIE improved the quality and safety of its citizens. Approximately 200 patients were transferred from NYU Langone Medical Center to two other hospitals when a backup generator failed. Thanks to the state’s HIE, medical records were readily available making a smoother transition for patient care.

Indiana leads the country with five HIEs:
  1. Indiana Health Information Exchange (IHIE)
  2. HealthLinc (A HealthBridge partner)
  3. HealthBridge
  4. Michiana Health Information Network (MHIN)
  5. Med-Web




Here are some questions and answers that may help you understand HIEs and their potential benefits.

What are the advantages of participating in an HIE?

An HIE provides benefits for you and your patients:

  • Availability of information where and when it is needed
  • Fewer duplications of testing
  • Reduced operational costs through gained efficiencies and automation of manual administrative tasks
  • Integration of sick-care with well-care
  • Availability of clinical decision support tools to promote effective care
  • Improved public health reporting and monitoring
  • Disaster recovery capabilities
  • Less staff time spent on quality reporting
  • Ability to verify claims-based measurement for accountable care organizations and other emerging payment models with HIE clinical data aggregated across facilities
  • Qualification for meaningful use funds

What types of services are offered by HIEs?

Services vary with each HIE, but possible functionalities for HIE include:

  • Connectivity to EHRs and electronic prescribing applications
  • Health summaries for continuity of care
  • Clinical decision support tools
  • Connectivity to immunization registries and prescription drug monitoring programs
  • Electronic laboratory ordering and results delivery
  • Consultation/referral and electronic referral processing
  • Clinical documentation
  • Public health reporting
  • Quality reporting
  • Prescription fill status

What types of data are exchanged by HIEs?

The data shared varies with each HIE and requires close evaluation before you sign with an HIE. Here are some possibilities:

  • Care summaries
  • Emergency department episodes/discharge summaries
  • Inpatient discharge summaries
  • Inpatient diagnosis and procedures
  • Outpatient visit summaries
  • Medication data
  • Laboratory or radiology orders and results
  • Claims data
  • Continuity of care documentation
  • Immunization information, such as the Children and Hoosiers Immunization Registry (CHIRP)

What are the costs to connect to an HIE?

Costs also vary among the five HIEs in Indiana. The amount of integration and services affect the bottom line. Some HIEs charge a monthly subscription fee, according to Andrew Vanzee, statewide health information technology director for Indiana.

“Monthly costs per provider can vary from free to the cost of a typical cell phone plan,” explained Vanzee. There are also costs paid to the EHR vendor to purchase the interfaces necessary to share information electronically. Every vendor has different price points for these interfaces.

“I expect many of these costs to come down over time,” Vanzee said. “There is a lot of market pressure on EHR vendors and health information exchange entities to offer services at a competitive price point.”

Vanzee advised the key to selecting the right HIE centers on the types of data accessed and the level of integration with the EHR workflow.

“Explore what your colleagues in your community are using and the level of services offered,” he advised. “Try to obtain access to the greatest amount of data pertinent to your patient population, such as lab and diagnostic results, immunizations, public surveillance submission and consolidated care summaries.”

Vanzee can answer your questions regarding HIEs, meaningful use and other incentive programs. Contact Vanzee here.

Find more information about HIEs, including contracting tips, on the AMA website.

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