Most doctors use Electronic Health Records (EHRs) to record notes during and after appointments, and to keep digital records of patient-related care, including test results. Digital records have many advantages over paper records but are far from perfect.
EHRs are time consuming for doctors and can negatively impact the quality of the doctor-patient interaction during appointments. Some doctors are so aggravated with EHRs, they have gone back to paper records, but EHRs are here to stay. (Read my blog post from 10-9-17 to learn more about how EHRs are stressing out doctors.)
Because there is no universal EHR system, doctors use EHRs which are often incompatible with the EHRs of other doctors. This makes it difficult for doctors to share information on mutual patients. Health information exchanges (HIEs) allow doctors to easily share patient data, eliminating many of the issues associated with incompatible EHRs.
It’s important for all your doctors to know everything about your health.
Most of us have a team of doctors managing our care, generally a primary care doctor and specialists. To get the best care possible, each doctor must have access to your complete records. Without all of your medical information, it can be hard for your doctors to make informed decisions about your care.
The difficulty in sharing patient data can increase the risk of dangerous drug interactions. When a doctor doesn’t have a current list of a patient’s medications, he/she may prescribe a medication that interacts negatively with other medications taken.
Lastly, the lack of a complete patient history can cause doctors to order unnecessary duplicate tests. This increases overall healthcare spending, and can harm patients since all tests involve a level of risk.
The lack of health information can cause serious issues in the ER.
The lack of a universal EHR system can also cause serious concern in emergency rooms. ER doctors may have little or no information about a patient’s existing conditions and treatments. If a patient is alone and cannot speak, ER doctors may make care decisions with little or no background information.
EHR systems impede record sharing among doctors.
There is a lack of collaboration among providers, payers, government, associations and vendors regarding the design, use and laws of EHR systems. EHR systems are often incompatible with EHR systems created by other companies. Sometimes EHRs are even incompatible with other EHRs created by the same company. This makes it hard for doctors to share patient health information.
Entering patient data is time consuming.
Doctors are struggling with managing patient data. They are particularly overwhelmed by the number of text and PDF files received from other doctors that must be manually entered into their own EHR system. Because the information received is often in different file formats, doctors must sort through the data to find the information that is relevant.
What is a health information exchange?
Some doctors share and access information through a health information exchange organization (HIE). An HIE allows medical professionals who use different EHR and IT systems to send and receive patient information.
The goal of an HIE is to ‘facilitate access to and retrieval of clinical data to provide safe, more timely, efficient, effective, equitable, patient-centered care.” HIEs can also be used by public health professionals in their work to analyze the health of populations.
What types of exchanges are there?
There are several different types of HIE and HIE organization (HIO) in the US:
- State-wide HIEs – run by the governments of their respective states.
- Private / Proprietary HIEs – focused on a single community or network, often based within a single organization, such as hospitals, payers, and software vendors. There can also be disease-specific HIEs.
- Hybrid HIEs/HIOs – often collaborations between organizations, such as an accountable care organization (ACO) and a vendor network, within a state or region.
- Regional / Community HIOs – inter-organizational, usually non-profit.
How do HIEs and EHRs differ?
HIEs offer benefits that EHRs generally do not, including several that directly address the issues of EHRs that can impact patient care:
- Care coordination – HIEs allow data to move across platforms and among service providers in real time. Many EHR systems do not talk to each other, which creates delays in patient data sharing.
- Record Locator Services / Master Patient Indexes – HIEs create a continuous community record for each patient, making patient identification easier among multiple doctors.
- Clinical messaging – standard HIE services often include laboratory results, emergency room notes, medication lists, discharge summaries, progress notes, radiology results and surgical notes.
How do you enroll in an HIE?
Enrolling in an HIE can only occur if your doctor is part of an exchange. In many cases, doctors ask patients to make a “consent decision” to allow the sharing and accessing of their information as part of the HIE.
Will being part of an exchange positively impact your care?
Yes! Being part of an HIE will make it significantly easier for your doctors to share and access your information which can go a long way to making sure that you are receiving the best care possible.