Health Information Exchange: Best Practice in the Medicine Industry
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Introduction
Best practice in the medicine industry is regulated by a variety of rules and acts of legislature. One of the principles of best practice is access to information in time to make diagnostic decisions for the most precious asset of human nature-life. The Office of the National Coordinator for Health Information Technology is tasked by the congress to ensure that there is regional independent and government based health information data sharing platform. Data sharing in health industry is necessitated by the fact that patients receive health services for a variety of health facilities. In addition, at the same time medical history is an important aspect in any diagnosis to ensure there is proper prescription of the drugs to the patients (Ann, 2011). In this paper, we analyze how health information data sharing has been affecting the United States of America health industry.
Outline US history of HIE
Health information exchange in the United States can be termed as a work in progress as the development of exchange communities still is formed. However, there is a considerable ground that is already covered with formation of independent and government oriented data sharing communities. In the study of Health Information Exchange, the evolution of Office of the National Coordinator for Health Information Technology is a good start (Ann, 2011).
Office of the National Coordinator for Health Information Technology
The office as noted above is mandated in overseeing intelligent data sharing across all the states in America. The office, which comprises of the staff in the U.S. Department of Health and Human Services, had its first coordinator appointed in 2004. However, the need to have the office of the coordinator empowered led to the enactment of Health Information Technology for Economic and Clinical Health Act five years latter (Ann, 2011). The office operates in a five point policy-line; crusading for the institution of healthcare information infrastructures, issuance of certificates to the Health Information products, coordination of the Health Information technology Policies. It creates a platform for reception of data across the regional and national level and, ensuring that there is a national coordination for all the regional Health information organizations (Margret, 2011).
The first national coordinator was David Brailer who was in office up to 2007. Other national coordinators have been Robert Kolodner, David Blumenthal, Jacob Reider, and Farzad Mostashari. The current office holder is Karen DeSalvo who was appointed in 2013. For better coordination of the office of national coordinator, the Office of Consumer e-Health was formed in 2012. The current head of this office is Lygea Riccardi who has been at the helm since the office was created (Ann, 2011).
Case study of the Regional health information exchange communities in United States
At least ten regional health information communities of exchange have proven that the health exchange program can be a success. These communities include,
- Utah Health Information Network
- Michigan Health Connect
- Michiana Health Information Network
- Indiana Health Information Exchange
- Harvard Pilgrim Health Care
- Frysian Health Information Exchange
- Delaware Health Information Network
- Colorado Regional Health Information Organization (CORHIO)
- Chesapeake Regional Information System for our Patients (Ann, 2011)
Chesapeake Regional Information System for our Patients is perhaps the oldest regional health information community of exchange. The management is drawn from four organizations in the state of Maryland. The exchange community shows how both health organizations and the medical schools can be involved in health data sharing (Margret, 2011). The University of Maryland medical system was significant in the development the exchange community.
In Colorado, CORHIO has been able to help over seven hundred doctors to come up with a platform where they can share patient data. The program in Colorado has 28 medical institutions taking part. In Delaware, the program has been enhanced through a private-public partnership, which is undertaken by a non-profit organization incorporated even before health information exchange policies were laid out (Ann, 2011). Delaware Health Information Network was registered in 1997 and the enactment of the act gave it a mandate, which it carries out gladly. The organization boasts itself to track approximately 88 percent an annual survey shows that 10,000 medical reports are shared in Delaware (Melvin, 2010).
Friesland Regional Cardiology Network has specialized in cardiology, which makes navigation within the system databases easier due to low file accumulation as opposed to general medicine communities. One of the notable contributions that the community has given to the members is reduction of duration spent by patients in hospitals due to faster diagnosis. At least, a patient reduces his stay by one and a half days. Specialization in data sharing has also been experienced in Massachusetts through Harvard Pilgrim Health Care (Margret, 2011). The non-profit insurance organization has created a platform for data sharing through preferred Provider options that must be in its system. Each provider has Point of sale gadgets, which are directly connected to the organization’s system making its easy for facilitation of bill payment against patient’s account (Melvin, 2010).
Indiana Health Information Exchange has seen gradual growth from twelve hospitals to 93 in 2013. Only 20 hospitals have not joined the system and the trend shows that they shall be compelled to join the program in the future. The slow growth could be associated to the fact that the program was set out by one institute that also runs the program Regenstrief Institute. The institute is a think tank in medical information technology. An approximately 15, 000 physicians are associated with the program (Ann, 2011).
Almost all the health stakeholders and participants in Utah are involved in Utah Health Information Network, which is a broad based coalition. The platform prefers internet exchange to data exchange over phone and fax. The organization has over 90% of the medical industry stakeholders take part in the program. This has to be done while at the same time ensuring that patient privacy is maintained. Real-time supported Clinical Health Information Exchange (cHIE) currently in use is a great improvement from the systems used in 19998 when the community was created (Margret, 2011).
Michigan Health Connect is among the youngest health information community of exchange, which was created in 2009. The three organizations that were involved in the formative stage- Spectrum Health, Trinity Health, and Metro Health developed a platform to ensure that the messaging licensing systems they had were incorporated. Other medical institutions have since joined the program (Melvin, 2010).
Michiana Health Information Network has been able to improve its initial data sharing models that were formed in 1998. The initial target was for medical professionals and providers. Being a recognized institution, it was easy to expand its powers when the act came into power. Both specialty groups and hospitals in Midwest are part of the program (Melvin, 2010).
Benefits of HIE (underlying the justification for HIE)
Faster diagnosis
As noted in the introductory part of this paper, patient history is important in diagnosis of the patient. With each patient being served by many health facilities, health information exchange makes it possible for the physicians to have faster diagnosis of the patient (Melvin, 2010). Real-time systems are important in ensuring that the physicians are able to get the information from their desks.
Reduction of patient stay in hospital
As shown in the case of Friesland Regional Cardiology Network, specialized care could be made effective through data sharing. Cardiology requires time and patients use most of their time in hospitals. Data sharing ensures that the stay at hospitals is reduced by at least one and a half days. This can be interpreted as increased financial activity in the region since patients have more time to engage in nation building activities (Margret, 2011).
Secures payment of insurance policies in record time
Insurance companies integrated in health information sharing communities can be able to verify client information and make payments against their accounts in real time. This helps the insurance companies to reduce the legal battles for unpaid client bills and also reduces on recurrent expenditure since physical visits to the hospitals are minimized (Ann, 2011).
Synchronization of the programs to accounting system
For insurance companies using the health information exchange communities, it is possible to synchronize the system with the accounting systems. This would help in reduction in data compilation for accounting purposes since data entry for policy payments is done in real-time bases and sent directly to company databases (Melvin, 2010).
Helps in medical research
Data sharing for patients is important when medical institutions are doing research on either particular patients or illness. The data pooled from both internal sources and external sources is analyzed to come up with a research objective (Melvin, 2010). At times, the institutions may not be required to secure other sources for preliminary investigation of the study.
Ways that privacy and security concerns are addressed
Specific worries were raised but consumer organizations on the abuse of health information exchange by hospitals and other institutions involved in data exchange programs. However, the American Reinvestment and Recovery Act in 2009 among other legislature have been able to come up with clear guidelines for physicians that ensure privacy and security. There are three core principles that are aimed at ensuring privacy and security in health information exchange; directed exchange, query based exchange, and consumer mediated exchange (Ann, 2011). Directed exchange ensures that any data sent through health information exchange programs is encrypted to ensure that data transmission is safe and efficient.
Query based exchange only allows data exchange amongst the members of the exchange community. It is assumed that before any institution is allowed in a health information exchange program, thorough scrutiny for its capacity to maintain integrity is verified. A query system is used to determine legality of the provider before exchange. Consumer based exchange ensures that data exchanged is used primarily for the diagnosis of the patient and not for any other reasons (Margret, 2011). The patient has the right to take legal action against any institution, which shares and/ or uses data against these three principles.
Current challenges and ways to overcome them
Constituency covered by the exchange communities
As noted through the paper, not all hospitals have been involved in the health information exchange programs regionally and nationally. This is a great challenge since partial patient history may lead to wrong or misinformed diagnosis on the patient. Going forward, there is need for enactment of law making involvement in health information exchange a mandatory exercise for all hospitals and health facilities (Margret, 2011).
Regional legislation
In some states, there is need for enactment of law, which is used alongside American Reinvestment and Recovery Act in 2009. Lack of regional laws has made the facilitation of health exchange communities slow (Ann, 2011).
Challenges with the consumers
There has been fear among consumers of health products on safety and privacy of data being shared. This has led to low reception of the health information exchange program among the consumers, which has affected the goodwill of the law and the office of national coordinator (Melvin, 2010).
An un-uniform development of health exchange communities across the country
Development of health exchange communities across all states has not been uniform. As noted earlier in the paper, while some communities deal with specialized cases, others deal with general health information. On the other hand, there are health information exchange communities that are inclusive of all stakeholders while others deal with only a section of stakeholders in the medicine industry. These disparities in development of health exchange programs have reduced the pace albeit bringing confusion on which model is the best.