College of Law > Academics > Centers, Institutes & Initiatives > Mary and Michael Jaharis Health Law Institute > e-Pulse Blog > health-information-exchange
By Tamalyn Wandler /
September 1, 2015 /
Posted in: HLI News /
Imagine a world where you can walk into any physician’s
office and instead of having to fill out a chart with all of your medical
history, you simply type in your social security number, and all of your
information appears instantly. Every
blood work, vaccination, prescription, and doctor’s visit is instantly at you
and your provider’s fingertips. This is the goal of health information
health record (“EHR”), is “an electronic record of health-related
information on an individual that conforms to nationally recognized
interoperability standards and that can be created, managed, and consulted by
authorized clinicians and staff across more than one healthcare organization.” An EHR, working alongside a functioning health
information exchange, is critical
to the transfer of healthcare information between patients’ providers.
Health information exchanges allow the medical field to
communicate faster and more efficiently.
health information exchange gives doctors, nurses, pharmacists,
other health care providers, and patients the ability to appropriately access
and securely share a patient’s vital medical information electronically. This access of medical information to medical
professionals can improve the speed, quality, safety, and cost of patient care
throughout the country.
There are currently three forms
of health information exchange: directed exchange, query-based exchange, and
consumer-mediated exchange. Directed
exchange gives providers the ability to send and receive secure medical
information electronically to support corresponding care and prevent
duplicative treatment. Query-based
exchange is used by providers to search and discover a patient’s accessible
medical records; this is often used when delivering unplanned care. Finally, consumer-mediated exchange provides
patients with access to their health information, allowing them to manage their
health care online. This exchange is
similar to how one might manage their finances through online banking.
Health information exchange is not an entirely new
advancement in the medical field.
HealthShare Exchange of Southeastern Pennsylvania (HSX) is one example
of this technology and its vast capabilities.
In 2012, HSX received
a 1.5 million dollar grant from Pennsylvania for startup costs and
implementation; support is also coming from acute care hospitals and insurance companies.
In 2013, HSX went live with clinical
data exchange. The data exchange at HSX,
led by executive director Martin Lupinetti, is bringing together a membership
of over 50 hospitals, medical practices, clinics, and insurers. The exchange allows healthcare professionals
to share patient health records and claims data, making it all accessible to
inpatient, outpatient, and clinic settings at the point of care. HSX is special among health information
exchanges nationwide, by serving one of the largest population’s through a single
integrated platform. HSX not only uses
direct protocol by offering encounter notifications, it also utilizes query-based
services. By 2016, the health information exchange hopes to connect 15,000
providers, representing 100 percent of practioners and 90 percent of hospitals
in the greater Philadelphia area. Should the health information exchange
succeed, it will be a model for other regions to follow in their efforts to
take on a large-scale collaborative effort with both payers and providers.
In an era where data breach is an always looming
possibility, and health care providers’ HIPAA requirements are restrictive,
protecting a patient’s privacy is an utmost concern for physicians. Due to this, it is understandable why
providers are hesitant about entering into a health information exchange
program. In 2007, surveys
showed that only four percent of physicians in the United States had
a fully functioning electronic health record. Today, this number has increased as the
technology within health information exchange is beginning to advance, as seen
As more providers are getting involved with health
information exchanges, more issues are beginning to surface. In an article
published on June 1, 2015 discussing the roadblocks faced by doctors trying to
implement programs, Mark Friedberg, a senior natural scientist at RAND, is
quoted saying: “The underlying problem is EHRs don’t talk to each other very
well.” This is because each information
exchange is different, making it difficult for providers across the board to
access the information efficiently. So,
even though the purpose behind these exchanges is for patient’s information to
successfully transfer between providers to improve their care, doctors are
prevented from moving forward every time the information enters into a
different type of information exchange.
Establishing universal standards for all health care providers to abide
by can rectify this issue.
Although there are privacy issues with health information
exchanges, such as possible data breaches and strict requirements, and issues
with the exchanges’ ability to transfer information effectively, health
information exchange is the future. The
benefits for the patient outweigh the burdens tenfold, and as the technology in
this field increases these benefits will be more evident.
Originally from South Jersey, Tamalyn
attended Loyola University Chicago where she received a B.A. in Political
Science and a B.S. in Criminal Justice & Criminology. A Health Law Fellow
and current 2L from DePaul University College of Law, she has a passion
for Health Law Policy and Healthcare Compliance.