Although health information exchange (HIE) has been around for more than a decade, the pandemic and natural disasters have highlighted the value that HIEs offer local, regional and nationwide data exchanges to improve the quality of care. In this post, we’ll explore the value of HIEs amid disasters, ever-increasing regulations and as part of a community outreach strategy.
Connectivity during natural disasters
As the world began to grapple with the global pandemic, health systems started preparing for the potential surge of patients requiring hospitalization. Emergency department and ICU bed capacity was expected to be short as the rates of infection climbed to higher levels than those previously seen. Additional capacity needed to be established fast while patients started to transfer to other facilities with available beds. Temporary field hospitals were rapidly deployed where the need was expected to be highest. As patients moved to different providers and new facilities needed an IT infrastructure to support patient care, those organizations with HIEs quickly established connections with other primary care and acute facilities, providing a patient’s comprehensive health information when it was needed most.
This isn’t the first time HIEs have played a key role in an emergency. From wildfires to tornados to hurricanes and floods, the connectivity HIEs provide allows ongoing access to patient data in some of the most dire situations.
The Cerner HIE expands connectivity beyond local facilities or regional networks to include the three largest organizations, enabling nationwide document exchange: eHealthExchange, CommonWell and Carequality. This means patients can access their medical records wherever they receive care.
When natural disasters forced providers to transfer patients to other facilities, move injured patients to a specialty care facility or evacuate communities, the Cerner HIE offered access to a patient’s medical history, medications, complications, and allergies and immunizations ─ improving continuity of care during a time of crisis.
Regulations and interoperability
In the early ‘90s, data exchange networks emerged at the state and local levels, driven by private collaborations or with the encouragement of the state. Eventually, a focus was placed on the need for national data sharing and the Office of the National Coordinator (ONC) was established in 2004. This initially resulted in the formation of the nationwide health information network that became eHealth Exchange, a governance and trust framework within which parties could exchange data among each other according to agreed standards and is now migrating to become a network.
CommonWell, a network that enabled orchestrated access to multiple locations where a patient has data based on a centralized record location service, was established with Cerner as a co-founder. Carequality was established around the same time to develop a governance and trust framework that empowers networks to connect with more flexibility than eHealth Exchange.
With the enactment of the 21st Century Cures Act in 2017, the ONC was chartered to develop or support a framework to further align and expand nationwide interoperability across stakeholders such as providers, payers, consumers, research organizations, public health officials and others.
The ONC focused on two key elements essential to realizing a foundation: A Common Agreement (CA) and a QHIN Technical Framework (QTF). These elements establish trust, governance and technology components for networks to adopt and will be ready for adoption in the near future.
In parallel to the ONC’s Final Rule on information blocking, the pandemic has put the spotlight on the U.S. public health infrastructure. To date, there hasn’t been a federal requirement to adopt all relevant interoperability capabilities and standards to consistently communicate public health data, such as syndromic surveillance, reportable condition test reports, case reports, immunizations, vaccine adverse events and other data critical to public health agencies.
A strong industry focus on advancing the public health interoperability infrastructure is essential to:
- Streamline reporting at the local, state and federal levels
- Reduce multiple submissions of the same data to multiple agencies
- Build on data already available rather than increase redundant documentation
- Report data through the appropriate workflows
National networks will have an important role as well to make this a reality. It will be crucial to not only report to public health entities but also to reach out to other organizations where a patient received care for additional data to complete a patient’s record. This is a necessary step to perform the relevant analysis and research needed to understand a disease outbreak, and in the worst case, a pandemic.
HIEs as a community outreach tool
HIEs can also be a tool for community outreach and business growth across the health care continuum. The Cerner HIE facilitates data sharing to affiliated and non-affiliated community health care venues; state and national registers; Picture Archive and Communication Systems technology used to capture, store, distribute and then display medical images; and many other external data sources. By enabling direct consumable data through a shared viewing tool, health care providers have a branded data exchange that can extend to their community and help drive business growth through community-based referrals.
By enabling a comprehensive care provider view of each patient’s chart, either within the electronic health record (EHR) or through a portal, the Cerner HIE provides a secure, scalable, EHR-agnostic approach for data integration across all connected data sources. The HIE provides key interoperability capabilities that can support state, regional and national use cases to optimize care delivery through its master person index, record locator and record exchange services. The Cerner HIE is a key component that augments the medication reconciliation workflow and affords the physician more time to care for the patient by aggregating a patient’s long record across disparate systems to mitigate gaps in care.
HIEs provide value in times of crisis and in times of more routine patient care as well. The delivery of care for patients is not confined to a single venue and spans disparate EHRs. As a result, patients are often asked to recall details of their personal medical history – immunization history, current medications, past procedures – leading to undue strain on the patient and a complicated care delivery process for the provider.
To learn more, register for the virtual Cerner Health Conference 2020 session, “Interoperability in action: how leveraging a health information exchange (HIE) can improve connectivity.”