Health Information Exchanges (HIEs) are expected to bring about a huge difference in the healthcare industry because of the nimbleness they are to suppose bring to data availability. This will also mean healthcare software testing will also pick up steam. There are some EHR vendors who currently offer the provision to physicians to exchange data with other practices which are registered to them. Some even go to the extent of offering all other features as are found in standard HIEs to them. But they are restricted in size and scale since it is only those physicians which are registered with the vendors which get entitled to draw the benefits.
HIEs go much beyond. These can be privately or publicly held and help in the transmission of clinical information from EHRs to participating physicians and providers. Most of the information is very holistic and helps in reducing the operational costs and improving the efficiency of practices. EHRs on the contrary hold a lot of information apart from the clinical data like demographics, allergies, laboratory reports etc. The potential benefits made available to group practices and physicians are many. By receiving and sending information, these entities benefit in a number of ways like.
* Automation of their administrative tasks
* Availability of real time information at the point of care
* Transparency of processes
* Availability of Decision Support Tools
* Reduction in operational costs
* Qualification for Meaningful Use Incentives
* Increased Competitive advantage
* Improved quality of services
There are many other benefits offered by HIEs in addition to the ones listed above. However, it is not mandatory to find all of these offerings at a single HIE. It is left to the physicians to exercise their judgment before deciding to join one such organization. There are many reasons for the buzz around creation of HIEs. Needlessly to say that they enhance the degree of safety, quality and cost reduction otherwise possible without their usage. But one of the major driving factors has been the push provided by the Federal Funding.
Through the HITECH ACT, which stands for Health Information Technology for Economic and Clinical Health, an amount of 2 billion dollars has been put aside by the federal reserve for creation and expansion of HIE infrastructure. HIEs fall under the purview of both the State, as well as the Federal government laws for finalizing the regulations of its operations esp. related to the privacy and security concerns of handling patient information. With the broad guidelines made available by the Federal government, the state laws determine the rules to be followed to set up the infrastructure, get the required certification to operate and specific ones for patient information protection. HIEs as such do not directly fall under the HIPAA act. But since it has to deal with entities which are covered by HIPAA e.g. providers, clearing houses etc. HIEs are expected to exercise and follow all the rules so as to comply with the privacy and security provisions as per the Act.
HIEs can act both as repositories and conduits for health information based entirely on the model that they want to follow. In the centralized model, data is stored in a central repository and is made available to members based on need. The advantage of doing this is that it leads to standardization of data. There are policies defined for ensuring this. In the federated model, the data stays at the source with HIEs providing pointers to them. This makes it possible for providers and physicians to get more control over the data unlike the previous one.
Overall, the involvement required by physicians in HIE governance is critical to their fraternity. From knowing how the model is developing in their states to how their data will be used, all this is important for physicians they decide to join one. There is one school of thought which is kind of making the physicians slightly apprehensive about their participation in HIEs. According to them, the data which is available with HIEs could be used to evaluate physicians or for profiling purpose. Thus all the more reason for physicians to know who has what access to the data available with HIEs and how is it supposed to be used.
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The future of Health Information Exchanges