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November 30, 2010

HIEs as a vehicle for Meaningful Use

Meaningful use should not be seen just as installing a certified EHR and generating the required reports. Ability to exchange Health Information securely over the internet is one of the foundations that need to be in place for realizing the key benefits of improved quality of care and patient safety at lower cost. While most of the stage 1 criteria may not have a direct dependency on Health Information Exchanges (HIE), you can expect to see increased relevance of HIEs in near future, in the context of implementing some of the Meaningful Use (MU) requirements.

Stage 2 of MU will focus on increased use of decision support. HIEs will facilitate integrated health records of patients across providers which is a key requirement for effective clinical decision support. HIEs will also play a key role in enabling better care coordination, which is a critical success factor for better clinical outcomes, a key focus area for stage 3 of MU.

The success of HIE would depend on the functionalities it offers and the extent of its adoption among the provider communities. A collaborative approach is required with participation from all stakeholders to build a successful HIE. A HIE is expected to facilitate exchange of Clinical information among the care providers, routing of referrals/authorizations and Lab orders/results and prescriptions, exchange of CCD between EHRs, secure communication between 2 providers and sharing problem lists/active medication and chart notes over the health information network. It can also host EHR systems within the network for use by providers on a pay-as-you-use model. Once the majority of the providers have been on boarded, it will act as an important source of information for disease registry and public health reporting.  Secured data exchange, identity management, non-repudiation, consent management, Record locator/Master patient index and provider directory are the key foundational components for delivering the above functions. Additionally, the exchange should be able to support interoperability and multiple vocabularies through effective vocabulary translation.

We are seeing increased activities in the HIE space, particularly in last one year, with the financial support from government providing the much needed impetus. We can expect even more buzz around HIEs as more community health information exchanges, RHIOs and states coming together to establish this useful foundation for meaningful use.