How HIEs are Becoming Essential to Clinicians
The forces that are making health information exchanges essential include exchanging summaries of care when EHR integration is not yet present and responding to business pressures such as accountable care.
This article appears in the September 2015 issue of HealthLeaders magazine.
As the industry turns its attention to interoperability, the nation's health information exchanges—some regional in nature, some statewide—are helping clinicians avoid productivity-sapping phone calls and faxes, and meet some challenging meaningful use requirements.
The forces that are making these HIEs essential include streamlining workflow utilizing Integrating the Healthcare Enterprise's EHR-to-EHR integration and Direct secure messaging connectivity built into meaningful use–compliant EHR software, exchanging summaries of care when EHR integration is not yet present, and responding to business pressures such as accountable care.
Pennsylvania: Making the transition
The Keystone Health Information Exchange connects 20 hospitals, 239 physician practices, and 30 home health locations primarily located in 31 counties in central, northern, and northeastern Pennsylvania, as well as 69 long-term care facilities spread throughout the state.
"We first went live in 2007 with a pretty rudimentary system of just connecting a few provider portals that were being offered by different healthcare systems and making it available through a single platform," says Jim Younkin, director of KeyHIE. Younkin is also IT director for external customer relations at Geisinger, a system that operates and participates in KeyHIE and itself serves more than 2.6 million residents throughout 44 counties in central and northeastern Pennsylvania.
In 2009, with funding from the U.S. HHS Office of the National Coordinator or Health Information Technology's Beacon Communities program, KeyHIE enabled a registry and information repository based on Cross Enterprise Document Sharing (XDS), a health IT standard developed by the nonprofit organization IHE, for storing and retrieving documents for providers who belonged to KeyHIE.
In fall 2013, use of KeyHIE leapt when it activated a notification service. "Any time a patient presented at a hospital or emergency department participating in KeyHIE, either as an inpatient or at an ED, we would send those alerts," Younkin says.
At the same time, KeyHIE successfully connected EHR software that had the ability to consume records via IHE's XDS protocol and present these records to clinicians as part of their regular workflow—a marked improvement from traditional HIEs, which require separate log-in via a physician portal to access information. In May 2015, 559 users of the HIE accessed information via the portal, with 461 using XDS-powered access within the EHRs themselves.