Extending HIEs to Improve Healthcare Interoperability

Electronic health information exchange (HIE) has become an essential tool as healthcare professionals explore ways to improve patient outcomes effectively and efficiently to promote value-based care.

Healthcare practitioners must be able to collaborate and coordinate services with other healthcare providers to coordinate care informed by accurate patient information; this involves the exchange of sensitive and confidential patient information. Traditionally, these exchanges were done by fax or in person, which slowed down clinical productivity and delayed patient care.

Sharing information electronically is much more efficient. Disparate systems must be able to communicate with each other when a plethora of information critical to patient care is accessible. Electronic health information is necessary to make a synchronized health system possible, secure and safe.

In healthcare, HIE alleviates the stress of requesting patient information inefficiently. HIEs ensure that comprehensive patient data is available to the healthcare providers who need it, whether through medical devices, wearables, various information systems or patient portals, all while adhering to applicable usage standards and HIPPA requirements.

Finally, this paradigm enables seamless collaboration across a continuum of services, which is essential for high-quality, value-driven healthcare.

Authorized entities (such as doctors, caregivers, insurance organizations or hospitals) can use HIE integration to exchange protected health information that is necessary for patient care. The transmission and storage of medical data is feasible with the development of the HIE interface when interfaced with various medical data management systems and data sources, such as:

  • Wearables and medical devices
  • Health related software
  • Information systems in hospitals (HIS)
  • EHR/EMR stands for Electronic Health Record/Electronic Medical Record.
  • Laboratory Information Systems (LIS)
  • Practice Management Systems (PMS)
  • Patient Management Software (PAS)

Without HIEs, a physician who wanted to access patient information from any of the above databases would have to visit each independently to get the information they needed. HIEs create a more centralized source of data, allowing healthcare providers to make a single request to access and obtain patient data from many sources from the final data storage location in an EHR/EMR.

Interoperability allows systems, applications, and devices to communicate with each other, opening up enormous value creation opportunities for healthcare providers. HIEs enable secure access to these value-driving health datasets through application programming interfaces (APIs). Patient data can be retrieved from clinical data sources or repositories via REST, SOAP, and SMTP APIs and delivered to the requesting healthcare destination.

The notion of sharing health information inevitably raises issues of security and privacy for patients. Interoperability between HIE solutions depends on compliance with healthcare regulatory standards such as HL7 and FHIR because the security of sensitive patient health information is paramount in the healthcare industry.

These anxieties are understandable, but they can be easily dispelled. Privacy regulations can be used by healthcare software developers with deep industry knowledge to ensure full electronic compliance.

The semantics used in sharing health data is codified by the HIE Coding Terminology Guidelines. Terminology, structured vocabulary, code sets and categorization systems are among the standards developed by stakeholders ranging from the American Medical Association (AMA) to the World Health Organization (WHO).

Data extracted from patients should be able to be reviewed and interpreted by healthcare providers. The Healthcare Information and Management Systems Society (HIMSS) specifies that usage standards should be followed independent of application or vendor to ensure that data can not only be transmitted but also displayed in an understandable and correct manner.

During development, a wide range of predefined HIE interface code standards should be followed, including LOINC, CPT, SNOMED, ​​RxNorm, ICD-9, ICD-10, NDC and other compliant clinical coding standards to HIPAA. Interpretation of medical codes ensures consistent identification of clinical reports when these codes are followed. Diagnoses and procedures are recorded using globally recognized codes, which facilitate the development of insurance claims and the calculation of accurate copayment amounts for patients.

To communicate patient information over the Internet to other healthcare providers, HIEs rely on secure, encrypted, and reliable transmission. The way data is presented has the potential to influence the type of care a patient receives. If doctors receive information about patients in an imprecise or ambiguous way, the likelihood of incorrect treatment increases significantly.

Additionally, architectures built using HTTP, FTP, MIME, or HISP message protocols are required for full integration into clinical data systems. CDA, CCD, X12, EDIFACT and NCPDP are just some of the predefined HIE interface communication protocols and EDI tools that must be followed. With these clinical data exchange standards in place, EHRs can securely “pass” data to the requesting provider while avoiding data breaches.

There are three types of HIE architectures, and the three exchange models are commonly used in healthcare systems to provide the best possible exchange architecture.

Direct exchange

Through secure electronic channels, directed exchanges are used to transmit information from one healthcare professional to another. Clinical information, medical appointment alerts, patient discharge information, test results, and other information may be sent by providers.

Query-based exchange

Providers can electronically search for patient information from other providers using “pulls” in query-based HIE exchanges. This type of communication is very useful in emergency situations or unscheduled medical appointments.

Consumer mediated exchange

Patients can acquire, manage, correct and transfer their own personal health information using consumer-mediated exchanges. This information may be shared with vendors and includes demographic, medical, and billing information. This sharing technique allows a consumer to update any incorrect or inaccurate medical history when accessing their own health information in order to detect errors.

HIEs can work independently (for a single healthcare facility), regionally, or as a hub for multiple networks. In a given market sector, these three levels frequently interact with each other.

Exchange network

HIE networks are made up of many independent HIEs that serve groups of patients. These networks are usually funded and operated by the government and operate at the federal or state level.

Regional exchange

Regional exchanges improve connectivity and efficiency of care in a given area. They are usually controlled by independent non-profit health information organizations and consist of various health organizations in a certain area. The government or various non-profit organizations may also fund and administer these exchanges.

For full visibility of health information, regional exchanges can connect local public health agencies, hospitals and physicians, as well as national entities such as insurers.

Private exchange

Private healthcare organizations fund, manage and use private or proprietary HIE exchanges. They bring together clinicians and patients in a specific area and aim to improve the overall clinical performance of the organization.

Practitioners and organizations may find it difficult to negotiate on their own the various confidentiality rules that govern the digital transmission of medical information. There is also the question of ensuring interoperability between the different systems. Healthcare companies can use HIE software solutions not only to securely communicate patient data, but also to increase overall productivity and profitability.

HIEs are changing more than just personalized patient care. Integrated HIE tools are currently used to manage everything from comprehensive clinical workflows to regional outbreaks.

As this industry is still in its early stages of development, it is impossible to say what these applications will be capable of in the next five years. However, one thing is certain: these breakthroughs will multiply exponentially.

Interface transport service, interface messaging, interface coding standards, HIE interoperability, data management and patient portal solutions are all available from KPi-Tech.

KPi-Tech is proud of his HL7 Compliant HIE Software Solutions, which enable full interoperability between all medical data management systems. Our integration services have taken a significant step in supporting the storage and transfer of medical data with the following medical data management systems: Laboratory Information Systems (LIS), Health Information Systems (HIS), Electronic Medical Record (EMR) (EHR)Electronic Medical Record (EMR), Practice Management Systems (PMS), Patient Management Software (PAS), Personal Health Information (PHR).

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