Health information exchanges (HIEs) have value in four significant arenas: Public health, population health, patient and family engagement, and patient care.
COVID has shown us that the top value of an HIE is syndromic surveillance. We witnessed the importance of being able to quantify the number of people infected, the severity of their symptoms and their vaccination status. For the next public health threat, we will need a highly functioning HIEs with connections to public health.
HIEs can provide the platform for care management crucial for superior patient outcomes and the move to value-based payment. HIEs aggregate social determinants of health data collected by other providers that can suggest health-related social services to improve patients’ health and avoid expensive downstream health care utilization.
Providers practicing with more complete data can decrease emergency department visits, hospital admissions, redundant lab and diagnostic imaging and medication errors as well as their attendant costs. Connecting to a local or regional HIE is the best action for ambulatory providers to ensure that needed clinical information is available at the point of care.
HIEs are an essential part of the current health care landscape. But to realize full value of HIEs, we must:
- Get all public health agencies to contribute data to HIEs
- Bring more provider offices onto HIEs
- Connect community-based organizations with HIEs
- Support oral health, behavioral health and post-acute care providers in acquiring electronic health records that send data to and receive data from HIEs
Public health agencies have been beneficiaries of HIE lookup but do not contribute much data to HIEs in some states. It is crucial that HIEs engage with state, county and local public health agencies in two-way data sharing.
Most hospitals and many large physician groups contribute data to HIEs. But the patients’ HIE records are incomplete without data from smaller provider offices, which encounter technical and financial barriers in contributing data to HIEs.
In addition to public health and small provider offices, the biggest data gaps in HIEs today involve oral health, behavioral health, rural health, critical access hospitals, post-acute care, tribal organizations and corrections facilities. Providers of oral health, behavioral health and post-acute care did not receive federal subsidies for their electronic records and there has been no equivalent electronic health record certification program. Many of these providers will need external funding to move their charting systems to vendors and versions capable of data exchange with HIEs.
In the future, an important additional source of useful data will be patients themselves. Patients reporting their own short, medium and long-term outcomes will add valuable information beyond what is collected in visits to offices and hospitals. With appropriate patient consent and trust, HIEs are an ideal place to store and analyze such data.
Historically, HIEs have been funded and governed by payers, hospitals and providers. Increasingly, HIEs will offer patient portals and involve patients in governance and consent aspects. Smaller provider offices and safety net clinics may need subsidies to connect. As public health receives much-needed increased funding, a case can be made that HIEs are an integral part of public health and deliver a cost-effective social benefit.
Download our new white paper to learn how HIEs contribute to public health, population health, patient and family engagement, and patient care, and what the next steps are in leveraging even further value.