Health care providers point at the problem that today, it is necessary to improve the ways of exchanging patient health information among health care institutions and facilities because of the necessity to guarantee the provision of efficient care. From this point, it is important to concentrate on the question of the health information exchange in the context of the health care system.
Today, Health Information Exchange (HIE) is discussed as the program promoted by the U.S. government to respond to the problem of the actual exchange of the medical data and information in the country (“Health Information Exchange” par. 2). Therefore, it is relevant to concentrate not only on the effectiveness of the system to guarantee the exchange of medical data but also on instruments and tools, like electronic health records (EHRs), that are used to promote the necessary improvements in the health information exchange system.
This paper aims to discuss the role and importance of information exchange in the health care system; to determine challenges associated with the issue and adopted HIE tools; to assess the role of the health care information systems in this context; to focus on specific processes in the health care delivery; and to provide the recommendations to implement HIE tools effectively.
Importance of Health Information Exchange
The importance of health information exchange among health care facilities and organizations can be discussed as high because it is necessary to provide health care professionals with the opportunity to share patient information actively and securely; to make decisions regarding prescriptions depending on the exchanged information; to use the information on health state and insurance in different facilities; to use efficient electronic forms; to have the access to the updated information; and to have the access to the complete medical history of a patient (Williams et al. 528).
To address the needs mentioned above and to contribute to the increase of the health care delivery’s quality, it is important to propose the infrastructure or system that can guarantee the effective exchange of information between health care facilities in the country.
HIE implemented along with EHRs can be discussed as a system that promotes the exchange of health care information to address the patients’ individual medical needs and to stimulate interconnectivity within health care organizations (“Health Information Exchange” par. 3).
The role of HIE for influencing the quality of health care in the United States is highly important because this system influences accessibility to the medical information and its further exchange with the focus on using standard formats. Furthermore, much attention is paid to the issues of confidentially and security associated with sharing the information.
Shortcomings and Challenges
The collaboration between health care organizations is often threatened because of the issue of health information exchange. Several years ago, the main problem associated with exchanging medical information was the necessity to share paper forms and documentation while guaranteeing the confidentiality of the patient’s personal information. Today, most shortcomings and challenges are associated with the necessity to organize the effective electronic exchange of the information when all the facilities receive equal access to the data.
One of the important operational challenges in the sphere of exchanging health information is the impossibility of exchanging medical information that is in a paper form effectively. However, many physicians still ignore the possibilities provided with the HIE tools (Williams et al. 529). Thus, it is also possible to speak about the challenge of adopting EHRs in health care environments and about the observed barriers because of the medical staff’s rejection of using the proposed technologies.
It is important to note that in spite of the active use of interoperable EHRs in many states, there are still regions and communities in the country where EHRs and other types of HIE are not adopted because of the lack of technological and knowledge base. For instance, the poor Internet access in different locations is connected with the lack of physicians’ access to medical information (Williams et al. 528).
Technical challenges include the necessity to work with fragmented or non-structured information that cannot be effectively shared by specialists in hospitals or laboratories because of the isolation of health information systems used in these organizations (McCarthy et al. 8). The other technical issue is interoperability. When the health information exchange is not developed and implemented as a system, it is relevant to speak about the problems with interoperability.
Technological shortcomings are typical for health care networks that focus on using traditional means for sharing electronic information. As a result, electronic files cannot be read appropriately, and there are risks of violating confidentiality and security (Williams et al. 529). To implement effective systems for exchanging health information in states and nationwide, it is also necessary to address challenges associated with the technical base of systems that are currently used in health care organizations.
Role of Health Care Information Systems in Overcoming the Challenges
Users of different systems for exchanging the information and those health care professionals, who choose the alternative ways of sharing the data, regularly face the above-mentioned barriers to provide health care effectively. In this context, health care information systems can provide tools for overcoming the observed challenges.
HIE systems and interoperable EHRs with integrated HIE can be discussed as such tools (McCarthy et al. 8). It is important to note that while using different information systems and software as well as non-interoperable programs, health care professionals become limited in their access to the required patient or other medical information (Williams et al. 530). Furthermore, unauthorized access to the data that needs to be exchanged is also possible when the requirement for interoperability is not followed appropriately.
From this point, local, state-level, and nationwide HIEs should be discussed in the context of health care information systems that provide users with equal and quick access to the necessary medical data. In this context, it is possible to determine two types of health care information systems that are directly associated with the problem of exchanging the information that can be adopted by the health care providers. These models of systems are centralized and decentralized ones (McCarthy et al. 12).
In order to address the challenges of the lack of access to the health care information within the community or within a state and the problem of different formatting, it is possible to use the centralized system when all health care providers utilizing the system can share the structured and complete information organized according to the certain format and stored in the database (“Health Information Exchange” par. 3).
The decentralized type of system means that the data is provided upon the request that is directed to a certain health care provider or organization (McCarthy et al. 14).
EHRs integrated within the health care information systems and providing opportunities for the health information exchange are also important tools to address the problems of sharing health care data. The effective use of health care information systems and EHRs for exchanging the data depends on using different programs to adapt the heterogeneous sources and information and to format the data according to certain standards (“Health Information Exchange” par. 5).
To guarantee the situation when all health care providers can use the adopted information system to exchange the medical data, it is necessary to focus on the interrelation of HIEs and EHRs depending on the facilities’ technological bases, requirements to data structures, and other experiences.
Specific Processes and Workflows
The use of health care information systems and health information exchange systems is important to improve the workflow efficiency in different facilities that can have problems with accessing important patient data. The use of HIE and EHRs appropriate for exchanging the information allows health care providers to increase the quality and safety of health care delivery because of saving time and resources.
It is important to implement HIE in different hospitals, laboratories, and other medical institutions because of the necessity to increase the capacity of facilities and focus on saving the time that is usually spent for maintaining the laboratory results or for making decisions regarding prescriptions (“Health Information Exchange” par. 3).
Furthermore, health information systems and such tools for sharing the data as HIE are useful to improve the referral processes and to reduce the percentage of medical errors associated with the access to the patient information and medical history.
Conclusion and Recommendations
The exchange of health care information between different medical facilities and organizations is an important factor to influence the quality the health care delivery in the United States.
From this point, it is significant to focus on the implementation of different information systems and infrastructures that allow sharing the information efficiently while using HIE and EHRs. To overcome the technical challenges associated with implementing different HIEs and EHRs, it is possible to concentrate on the following recommendations:
- EHRs and other HIE tools should be selected with the focus on the necessity of implementing local, state-level, or nationwide HIEs.
- The centralized or decentralized variant of the HIE should be selected for the network of facilities depending on the available technological base and needs of the community.
- The important stage of the process is the adoption of standards, formats, and homogeneous sources to provide different healthcare organizations with the same available data.
- To use the HIE effectively in different locations, it is necessary to adapt the local HIEs according to the resources available in the region. Much attention should be paid to simplifying standards and formats for recording, storing, and exchanging the data.
- The other important point is the necessity to address confidentiality, privacy, and security issues while selecting the HIE and associated instruments and while implementing the program in the health care facilities and organizations.
Health Information Exchange. 2014. Web.
McCarthy, Douglas, Karen Propp, Alexander Cohen, and Raj Sabharwal. Learning from Health Information Exchange Technical Architecture and Implementation in Seven Beacon Communities. 2014. Web.
Williams, Claudia, Farzad Mostashari, Kory Mertz, Emily Hogin, and Parmeeth Atwal. “From the Office of the National Coordinator: The Strategy for Advancing the Exchange of Health Information”. Health Affairs 31.3 (2012): 527-536. Print.