College of Law > Academics > Centers, Institutes & Initiatives > Mary and Michael Jaharis Health Law Institute > e-Pulse Blog > health-information-exchange

Health Information Exchange: The Future of Healthcare

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 exchanges.

An electronic 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.  Electronic 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 through HSX. 

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.