physicians and health information exchange (hie) what is hie? physicians and health information...
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Physicians and Health Information Exchange (HIE)
What is HIE?Physicians and Health Information Exchange (HIE)
What is HIE?
© eHealth Initiative & Foundation, 20062
Today’s Reality…
Have you ever had an afternoon like this?• Patient waiting in the room for follow up of
emergency room visit• Records not yet received
How long does patient wait? How long do you wait?What assumptions do you not want to make…
© eHealth Initiative & Foundation, 20063
Today’s Reality…• Data is stored in silos, across multiple stakeholder groups• Clinical research and public health is hindered by paper-based,
fragmented systems – costly and slow processes• Data is required from multiple sources to have timely, and effective
clinical decision support• Public health agencies forced to utilize phone, fax and mail to
conduct public health surveillance, detection, management and response
• Physicians spend 20 - 30% of their time searching for information…10 - 81% of the time, physicians don’t find the information they need in the patient record
© eHealth Initiative & Foundation, 20064
Why Health Information Exchange…
Health information exchange (HIE):• the mobilization of healthcare information electronically within a region or community. •facilitate access to and retrieval of clinical data across organizations to provide safer, more timely, efficient, effective, equitable, patient-centered care.
© eHealth Initiative & Foundation, 20065
‘HIT’ from ‘HIE’…Is There a Difference?
Health Information Technology (HIT) Local deployments of technology to
support organizational business and clinical requirements
Health Information Exchange (HIE) Infrastructure to enable data sharing
between organizations
© eHealth Initiative & Foundation, 20066
Example of Health Information Technology (HIT)
• Electronic Medical Record (EMR)• Management Information System (MIS)• Laboratory Information System (LIS)• Computerized Physician Order Entry (CPOE)• E-prescribing and order-entry only with (eRx)• Personal Health Records (PHR)
© eHealth Initiative & Foundation, 20067
Public Interest in Health Information
Consumer Experience with Patient Safety and Quality Information Percentage who say...
0 10 20 30 40 50 60 70 80
The coordination among the different healthprofessionals that they see is a problem
They have seen a health care professional and noticedthat they did not have all of their medical information
They had to wait or come back for anotherappointment because the provider did not have all
their medical information
Source: Kaiser Family Foundation/AHRQ/Harvard School of Public Heallth National Survey on Consumer's Experiences with Patient Safety and Qualtiy Information , November 2004
© eHealth Initiative & Foundation, 20068
HIE: Opportunities to Consider• Order tests, medications, referrals• Receive results (labs, imaging, dispensing records)• Get paid (claims, claims attachments)• Query (patient eligibility, allergies, diagnoses, meds, labs, other providers,
immunizations)• Send/receive a message/document (d/c summaries, consultation results)• Emergency alerting and situational awareness (PH alerts, system status e.g. ER
saturation)• Patient record access/communication (patient portal, e-visits, reminder/recall)• Decision support (powered by ALL meds, allergies, etc.)• Accountability (quality-safety-cost scorecards)• Surveillance (outbreaks, underserved, disease trends)• Collaborate (shared case management tools)
© eHealth Initiative & Foundation, 20069
Today’s Health Information Exchange Initiatives: What Are They Doing?
Primary focus continues to be building systems to support sharing of clinical information
DATA CURRENTLY BEING SHARED ELECTRONICALLY2006 SURVEY RESULTS
15%
26%22% 23% 26%
13%
22%26%
21% 22%18%
13% 11% 13% 12%
20%
9%
0%5%
10%15%20%25%30%
© eHealth Initiative & Foundation, 200610
Focus on Disease Management, Quality Reporting, and Population Health
Advancements in functionality to support improvements in quality and safety are evident. Traditional uses to support care delivery, a number are now expanding functionality
Data Exchange Functionalities in 2006
26%25% 24% 23%
20% 20%
14% 14% 13%
0%
5%
10%
15%
20%
25%
30%
Clinical
documentation
Results deliv ery Consultation/referral Electronic referral
processing
Alerts to prov iders Disease/chronic
care management
Prov ide quality
performance
reporting to
clinicians
Prov ide public
health electronic lab
reporting
Prov ide
disease/chronic
care management
© eHealth Initiative & Foundation, 200611
Physicians and Health Information Exchange: Tips for Success
• Trust and transparency Neutral entity that brings together multiple stakeholders
• Physician Champions needed• Incremental steps towards a long-term vision and strategy• Select HIE functions that make a clinical difference and improve
outcomes• Point of care and work flow
Accessible and integrated into routines to provide value• Data must be current and reliable• Ensure privacy and integrity of data
© eHealth Initiative & Foundation, 200612
Engaging Physicians in Health Information Exchange
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