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● Roundup: Health Information Exchanges (HIEs)

to document many clinical terms. “Myocardial infarction,” “MI” and “heart attack,” for example, all indicate the same diagnosis. When two providers document the same event in the EHR using diff erent terms, data duplication can result. While this minor duplication may seem harmless, these redundancies dilute eff ectiveness and muddle the HIE process. To improve HIEs among disparate provid- ers and platforms, organizations must continue to work toward semantic interoperability in an eff ort to standardize clinical terminology.

3. Increase technology adoption. Tools that allow health- care organizations to enter and access clinical data in real time – including EHRs and patient portals – enhance the accuracy, detail and overall quality of data exchange. Since change is always diffi cult, healthcare organizations must work to encourage technology adoption by implementing solutions that are easy to use, explaining potential benefi ts clearly and making the technology convenient by aligning it with providers’ workfl ows.

Ashish V. Shah, CTO, Medicity

The future of HIEs lies in the power of the network HIE has been around for more than a decade now, but it

really found its stride in the market with the passage of the HITECH Act in 2009. Since that time, the HIE conversation has tended to focus on the nuts and bolts of connectivity and integration – basic messaging transactions, formats, standards and terminologies.

I count myself among the HIE wonks who can have an impassioned conversation about things like HL7, CCD, IHE profi les and Direct. But the future of HIEs is not found in these discussions of how to build a standards-based network. We should have that fi gured out by now. T e future of HIEs lies in how organizations can use the network to improve business operations and the quality of healthcare. When all stakeholders in the healthcare continuum – regard- less of their levels of technology sophistication – become part of a network where information fl ows freely and securely, healthcare organizations will have the power to solve long-standing chal- lenges. Not only can they reduce medical errors by improving data sharing, they can also: • Reduce waste at transitions of care; • Drive consumer and provider engagement; and • Gather insights for administrators and providers operating in a post-reform era.

8 April 2013

A powerful network doesn’t just connect. It fi lters out infor- mation noise to deliver meaningful insights and drive quality improvements. It enhances patients’ understanding of their care. It helps physicians better serve their patients. And it helps health systems entering the realm of accountable care ensure their patients receive quality care. T e future of successful healthcare reform will be network driven.

Kris Joshi, global VP, healthcare product strategy, Oracle

Unlocking the hidden value of HIEs It’s time to apply the power of HIEs to the elusive goal of transforming population health. While HIEs are recognized as a critical enabling technology for EHRs, they also have enormous potential to impact care delivery and outcomes well beyond individual patients. Secondary use of the vast amount of data captured across the

healthcare ecosystem – including EHRs, claims/billing systems, research databases, clinical systems and laboratory systems, to name a few – will be essential to enabling and accelerating a new paradigm of population health. However, the largely transac- tional systems in place today were not designed with broader initiatives in mind and instead primarily support individual silos across the healthcare and health sciences ecosystem, which has precluded the integrated view that is essential for collaboration and secondary use of health data. HIEs can address these fundamental challenges and, when combined with context-specifi c analytics, these foundational technologies hold the key to enabling productive secondary use of healthcare information and the advent of a new era of healthcare delivery. To advance secondary use of health data, HIEs must support

de-identifi ed patient information, secure document exchange, clinical document indexing, a standard message format and an auditable document trail. With these capabilities, healthcare organizations can begin to easily share data with public health registries and enterprise healthcare data warehouses focused on advancing population and epidemiological research, extending the volume and richness of available information. From there, advanced analytics – with retrospective as well as predictive capabilities – can drive produc- tive use of secondary health data on a wide scale. By investing in a comprehensive HIE infrastructure, orga- nizations extend their ability to share data with other partners, which, in turn, can drive innovation in population health and new opportunities for collaboration.


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