Sep 07 2017

Health Information Exchanges Evolve to Boost Provider Interoperability

With the help of new technology and techniques, HIEs are emerging to improve interoperability and transparency across the healthcare system.

With the 21st Century Cures Act bringing interoperability front and center for the healthcare industry, health information exchanges are poised for growth. HIEs provide the ability to securely share accurate patient health information between providers, such as doctors, nurses or pharmacists, which can help to improve the speed, safety and quality of patient care while cutting costs.

Moreover, consumer-mediated exchanges can help give patients access to their own health information and empower them to make their own decisions. With a recent survey by CDW pointing out that just 29 percent of people would give their healthcare providers an “A” for their use of technology to engage with patients, providers may be looking to HIEs to help close this gap.

“HIEs are alive and well and we’re moving forward to support our communities,” Dick Thompson, chairman of the Strategic Health Information Exchange Collaborative, which counts 55 HIEs as members ( a 67 percent spike in membership since this time last year), told Healthcare IT News. “The exchanges have begun to readily identify value and they are monetizing that value to sustain themselves.”

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Connecting HIEs Across State Lines to Improve Care

So where are HIEs picking up momentum?

With the aim to improve interoperability across state lines for providers and patients alike, Great Lakes Health Connect (GLHC) in Michigan recently connected to six other HIEs. The collaborative pilot program between the seven HIEs, known as the Heartland Project, will provide real-time access to health data. It was launch by the Office of the National Coordinator for Health Information Technology and the Strategic Health Information Exchange Collaborative through funding from the Department of Health and Human Services.

All information from the participating health networks is stored in the Virtual Integrated Patient Record (VIPR) repository, which currently contains 8 million patient records.

“Great Lakes Health Connect is proud to participate in the Heartland Project and to offer our participants out-of-state information about their patients in real-time,” said Executive Director of GLHC Doug Dietzman, EHR Intelligence reports. “This expanded capability supports our goal of reducing the time required and the financial burden of exchanging health information among healthcare providers and across communities.”

The program follows another pilot project launched in January that created a home base for medical data from the Indiana Health Information Exchange, Michiana Health Information Network and East Tennessee Health Information Network.

“Each of our organizations is successfully exchanging healthcare data with providers in our own communities,” Kelly Hahaj, CEO of MHIN, told EHR Intelligence in a different article. “It makes sense that the next evolution is to connect our networks to enable a person’s medical information to be available whenever and wherever care occurs, appropriately and securely.

Using HIEs to Tackle the Opioid Crisis

Moreover, in July, the Nebraska Health Information Initiative, which operates a statewide health information exchange, announced it is ramping up to launch a program this January that will make it the first state in the country to require that all filled prescriptions be tracked.

The measure, which is essentially a more robust version of the prescription drug monitoring programs that have been adopted in 49 states, is designed to address the ongoing opioid crisis by tracking and making available information not just on opioid prescriptions, but all prescription drugs.

“By making narcotic details available to every doctor and pharmacist, providers can identify patients who are potentially at risk of abuse or doctor-shopping for medication,” Nebraska State Senator Sara Howard told Health Data Management regarding the legislation making the technology possible.

A Look at the Next Evolution of HIEs

The next generation of HIEs — HIE 2.0 — is already upon us. Heralded in by the Massachusetts eHealth Collaborative, Healthcare IT News reports that the latest version of HIEs include all the latest technologies:

The second generation is built on modern technologies, including cloud services, mHealth apps and [Internet of Things] devices, inexpensive storage and broadband connectivity and adjusted market expectations wherein consumers and caregivers demand electronic access to their records, not to mention the ability to share that data among providers.

But the third generation could go even further, tapping into IT infrastructure to aggregate not just provider data but also social determinants and behavioral health components. It could also help establish a connection between care quality and price, Thompson tells the source.

“We’re on the frontier,” he says. “HIE 3.0 will engage with patients. That takes a level of trust that is less about technology than it is about people and process and building networks of trust between individuals.” 

Injecting Security and Trust into Patient Data Exchanges

With the threat of ransomware attacks making cybersecurity top priority for many healthcare IT leaders, keeping HIEs secure is vital to their continued adoption and success.

To that end, blockchain is also entering the scene. The digital ledger software, which puts to use the technology underlying bitcoin, has the potential to inject further transparency, trust and security into HIEs, according to a recent report by IBM.

The report identifies three properties that will help to improve accountability and further transparency and innovation in the healthcare system:

  • Bit-string cryptography secures data integrity without violating HIPAA (the Health Insurance Portability and Accountability Act), which often limits real-time use and analysis of health data.
  • The majority of chain nodes confirm transaction validity through consensus.
  • Smart contracts authorize and notarize each transaction.

Moreover, the technology can help to gain patients’ trust since they will be able to track every interaction, Boris Shiklo, CTO at software development and consulting company ScienceSoft, writes in an Op-Ed on Forbes.

“Even if we can’t call blockchain a panacea for health information exchange yet, it still addresses critical pain points and brings greater transparency and trust,” Shiklo writes. “This is a chance to introduce a health-based data-sharing system that supports secure integration of care information across a range of stakeholders while protecting patients’ identity and giving insights on population health.”

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