Health Information Exchange

Health Information Exchanges (HIE) are organizations that provide a mechanism for the sharing of clinical and administrative healthcare data among healthcare institutions, providers, and data repositories. By already being facilitated with a diverse group of healthcare system stakeholders (hospitals, laboratories, and practicing physicians), HIEs have a great potential to integrate data exchange with public health agencies. As clinical information reaches the appropriate provider at the appropriate time and place, the bidirectional communication element ensures critical information is utilized.

The HIE program was established by DIPPC to develop a sustainable model for the provision of data to public health from HIEs in the medical community.

Primary Goal: Develop a sustainable source of data from HIE’s medical community to public health

Secondary Goals:

• Inclusion and participation with the Nationwide Health Information Network (NHIN)
• Assessment and delivery of American Health Information Community (AHIC) Minimum Biosurveillance Data Set (MBDS) recommendations
• Enhanced case reporting
• Bi-directional communication improvements

• Indiana – Indiana University, Regenstrief Institute, Indiana Health Info Exchange
• New York – NY State Health Dept., Health Partners
• Washington/Idaho – SAIC, University of Washington, PHIE, Washington DOH

In 2007, CDC funded the "Situational Awareness through Health Information Exchange (HIE) "project. The project's goals were to connect public health with HIEs and improve public health's real-time awareness of the health and status of healthcare facilities in communities. The purpose was also to improve bidirectional communication and enhance case reporting. CDC awarded three contracts to the Regenstrief Institute, Inland Northwest Health Services, and Health Research Incorporated.

• The Indiana Health Information Exchange (IHIE) has leveraged their clinical messaging service, DOCS4DOCS®, to improve the communication of information between public health agencies and health care providers. DOCS4DOCS® is a system designed and developed by the Regenstrief institute to deliver clinical results to physicians. As of February 2009 there were over 10,000 physicians utilizing the DOCS4DOCS® service throughout Indiana. Messages can be sent to all physicians or targeted to specific practices based on clinical specialty or geography. The IHIE leveraged DOCS4DOCS® to have public health agencies create alerts and submit them to providers through the system. In 2009 and 2010 public health alerts were sent by the HIE on behalf of the local public health agency to almost every physician practice in the jurisdiction using the DOCS4DOCS® system for H1N1 flu, syphilis outbreak, rabies information and treatment update, and new vaccination requirements for school.
• The New York HIE and the NY State Health Department were the first to implement the NHIN CONNECT Gateway as an interface for federal-state health information exchange. The NHIN CONNECT gateway is a software solution that helps agencies, and other organizations, share health-related information and securely links their existing systems to the NHIN. The NHIN CONNECT solution enables secure and interoperable electronic health information exchanges with other NHIN participating organizations, including federal agencies, state, tribal and local-level health organizations, and healthcare participants in the private sector
• The Northwest Public Health Information Exchange (NW-PHIE) in Washington and Idaho has evaluated their new influenza surveillance efforts against their existing influenza surveillance data feeds through the Influenza-Like-Illness Network (ILINET). They found the NW-PHIE data to be timelier, stable, more extensive, and broadly representative of the community. The NW-PHIE data accurately reflected trends in ILI activity and is well suited to monitor trends at the state and community level. As an automated data feed, NW-PHIE data is resistant to workload levels and seasonal fluctuations in reporting as seen among ILINET reporters. The data from the NW-PHIE has been timelier than both ILINET and traditional notifiable condition reporting.

Please see our Summary presentation on HIE and its goals and objectives for a broad description of the HIE program.