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Health Information Exchanges What private

Lessons can be learned from public health. By John Dunn

cross the country, private healthcare organi- zations (HCOs) are increasingly addressing their need to securely exchange healthcare data throughout their own facilities as well as with state and regional organizations via health information exchanges (HIEs). The federal government is driving this focus on HIEs with its State Health Information Exchange Cooperative Agreement Program, through which the Office of the National Coordinator for Health Information Tech- nology (ONC) is providing grants directly to states for the development of HIEs. Additionally, both Stage 1 and Stage 2 of the Centers for Medicare and Medicaid Services’ (CMS) meaningful-use program mandate that organizations that wish to qualify for incentives meet core measures related to HIE. With a number of established statewide HIEs, the suc- cessful completion of the federally sponsored Direct Project for simple exchange of healthcare data, and progress made to build a Nationwide Health Information Network (NwHIN), it’s clear that the public health sector has set successful precedents for the implementation of HIEs. This is espe- cially evident when one considers the extensive experience that state public health departments and the Centers for Disease Control and Prevention (CDC) have in electronic disease surveillance, reporting health statistics and working with HCOs to ensure that the right data is being transmit- ted to government organizations in readable formats and in a timely manner. As private hospitals and health systems look to connect their own systems and extend their IT reach beyond organizational boundaries with HIEs, it’s clear that there are lessons to be learned from similar deployments by public health organizations.


of their HIEs more as networks than as exchanges and develop a technology infrastructure that can adapt to meet future meaningful-use requirements, continue to be built to meet organizational needs and lead to high adoption by physicians, nurses and administrators. Public health entities have spent years creating statewide and nationwide networks for report- ing and disease surveillance. These networks have lowered the bar for participation for a wide range of participants, and currently, 48 out of 50 state public health departments, along with the CDC, utilize a common data-integration engine. These systems rely on extensive participation by external organizations and on dependable technology infrastructures to be successful, as do private HIEs.

Technical infrastructure Private HCOs need to ensure that their HIE infrastruc- tures meet regulatory requirements and line up with internal IT needs. Public health entities at the state and federal levels are well versed in managing systems that meet regulatory requirements and easily interface with IT systems used by external partners. Hospitals and health systems should think

12 September 2012

Certain health departments, such as the Mississippi State Department of Health, are beginning to link the many disparate components of individual public health records in siloed databases by implementing an enterprise master patient index (EMPI). For Mississippi, this will be followed by an implementation of a portal that compiles the components of an individual’s public health medical record so they can be viewed and updated from one user interface.


organizations should know when building HIEs

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