Health Information Exchange free essay sample

Consumers today have the ability to access information related to their daily lives or even information related to events happening on the opposite side of the world. However, if this same consumer needed access to his or her personal health information, the ability of the patient or their health care provider to obtain the information would be limited. (Medows) Personal health information is not used to its full potential to support effective and efficient care due to fragmented information creation and storage. Our fast-paced always on the go society calls for a change to this state of isolated, fragmented health information. Whether it be a patient relocated due to a natural disaster or being able to identify a patient who was prescribed a recalled drug, having access to health information no matter where the patient may be is necessary. (Vest and Gamm, 2010) Making health information technology (HIT) will not only enable healthcare consumers access to their own medical history but also ensure that healthcare providers have timely access to medical records, improve the ease and safety  of e-prescribing, improve payer reimbursement, and provide the information needed for population based health planning. (Medows) Policy makers, researchers, industry groups, and health care professionals agree that health information exchange (HIE) is the much needed solution. (Vest and Gamm, 2010) Health Information Exchange (HIE) What is HIE? The National Alliance for Health Information Technology defines health information exchange (HIE) as the process of sharing patient-level electronic health information between different organizations. This process is conducted in a manner that protects the confidentiality, privacy, and security of the information. (AHIMA, 2012) The ability to exchange health information electronically is the foundation of efforts to improve quality of care, improve patient safety, and reduce costs and thus proves the importance of health information exchange (HIE). (HealthIT) While HIE promises cost and quality improvements, to date there lacks substantial and consistent empirical demonstrations of the effectiveness of HIE. (Vest and Gamm, 2010) History of HIE Community Health Management Information Systems (CHMISs) In 1990, the Hartford Foundation initiated community health management information systems (CHMISs) through grants to seven states and cities. (HIT Knowledgebase, 2012) The systems were centralized data repositories that housed patient information. The main purpose of the system was for assessment purposes and to facilitate billing and patient eligibility information retrieval in order to reduce costs. However, none of these systems ultimately survived due to lack of affordable and effective technology. They developed in communities interested in the concept of HIE but with commercial endeavors rather than community stakeholders. (Vest and Gamm, 2010) These endeavors were primarily aimed at reducing costs by sharing data. In an attempt to overcome some of the pitfalls learned in 1990, CHINs employed decentralized data structures that made it less likely to violate some privacy concerns. (HIT Knowledgebase, 2012) Despite the fact that anywhere from 75 to 500 CHINs existed or were in the planning stages during the 1990s, most failed to survive. There are several reasons that led to this failure. First, there was a lack of focus on community stakeholders. (Vest and Gamm, 2010) In addition, technology vendors, who were building the systems to collect fees associated with electronic transmission, seemed to pit the interests of hospitals against those of community physicians. Finally, there was no clear return on investment. (HIT Knowledgebase, 2012) IOM Reports In 1999, the Institute of Medicine released the first of a series of reports that would ignite a national focus on patient safety and quality of care. This first report, To Err is Human, addressed the fact that healthcare in the United States is not as safe as it should be. â€Å"At least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented, according to estimates from two major studies. † (IOM, 1999) A follow up report in 2001 pointed out how health information technology (HIT) and health information exchange (HIE) can be used to reduce errors and improve efficiency and effectiveness of our healthcare system. This new national focus would determine how the history of HIE would continue to unfold. Hospitals have been identified as a primary financial contributor in a community but would also have the most difficulty in showing a return on investment. In addition, while privacy laws allow for the sharing of information between organizations for the purpose of patient care, RHIOs are still responsible for ensuring patient privacy. (Vest and Gamm, 2010) HIE Today A milestone year for health information exchange was 2009, in which Title XIII of the American Recovery Reinvestment Act was passed. This is better known as the Health Information Technology for Economical Clinical Health (HITECH) Act and is the most recent example of federal support for HIE. (Vest and Gamm, 2010) The HITECH Act incentivizes the use of electronic health record (EHR) adoption among providers who adopt certified systems and are able to demonstrate that they use these EHR systems in a meaningful way. The act also addresses privacy issues by strengthening privacy, security, and confidentiality. (HIT Knowledgebase) This builds on the previous administration’s call for interoperable health information technology and its creation of the Office of the National Coordinator for Health Information Technology (ONC). The Obama administration envisions a future of lower cost and higher quality healthcare, and rapidly growing adoption of health information technology is to be a key lever in achieving such a future. (Vest and Gamm, 2010) Benefits of HIE Benefits of health information exchange (HIE) can include improving quality  and safety of patient care; providing a basic level of interoperability among EHRs maintained by individual physicians and organizations; stimulating consumer education and patients’ involvement in their own healthcare; helping public health officials meet their commitment to the community; creating a potential loop for feedback between health-related research and actual practice; facilitating efficient deployment of emerging technology and heal thcare services; and providing the backbone of technical infrastructure for leverage by national and state-level initiatives. While there are many clear benefits that come with the adoption of HIE, improving quality and safety of patient care seems to be the most important. Achieving this long wanted goal will provide a connecting point for an organized, standardized process of data exchange. (HealthIT) However, achieving this goal will also require strategies for overcoming obstacles encountered in the past. Current Challenges The key challenges facing health information exchange (HIE) today are establishing a base of support, interconnecting technology, and establishing financial viability amid uncertainty. Building consensus and achieving full stakeholder buy-in at the beginning of an HIE project and maintaining that trust as the project moves forward is an important factor. Once sufficient participation collaboration is achieved, technical interoperability becomes the key challenge. As with any system development, the struggle with implementing HIE is how to create and maintain a sound financing model into the future. (NeHC, 2012) Establishing a Base of Support Healthcare technology executives face a need to connect an increasing number of providers and other stakeholders. Each stakeholder has different needs, work on different data platforms, and have different requirements for accessing and managing data. (Bizzaro, 2012) Validating the National eHealth Collaborative (NeHC) belief that a public-private partnership is key to success, the panelists agree that broad and sustained collaboration coupled with clear, structured communication among stakeholders at all levels is vital. (NeHC, 2012) Interconnecting Technology Individual EMR systems are not necessarily designed for interconnection, and  vendors as a rule have not yet been effective at creating technological bridges in an affordable or rapidly deployable way. (NeHC, 2012) Most healthcare organizations are burdened with managing multiple financial, administrative, and clinical systems on a variety of platforms. The challenge is to develop and execute a long-term strategy that will meet urgent and important interoperability needs while also placing the organization in the position to face downstr eam challenges or harness future opportunities.