There are three types of health information exchanges, explains Daniel Newman, MD, current CMIO of MEDfx, a company that assists with a spectrum of HIE implementation, and former CMIO of Boston Medical Center: Exchanges that connect hospitals with affiliated hospitals and physicians, exchanges that connect these types of exchanges within systems to statewide exchanges and statewide (and one day, nationwide) exchanges.
It is the first kind of exchange that hospitals and health systems should start planning if one is not already in place, says Dr. Newman.
"The purpose of an HIE is to send and receive information so providers have a more complete picture of the patient," says Dr. Newman. Tests and workups do not have to be duplicated between sites, and having a patient's history easily accessible through an HIE can "save the patient a lot of radiation, and a lot of time."
In a fee-for-service environment, talk of reducing testing and procedures can be "uncomfortable, because a lot of places get a lot of money from testing and other procedures," says Dr. Newman. Yet with the future of the healthcare industry, HIEs will soon show their many advantages.
Below, Dr. Newman details three benefits of utilizing a systemwide HIE.
1. Ability to track referrals. Dr. Newman believes in the future, systemwide HIEs will be seen by hospitals as essential tools to getting needed, and helpful, information. An example is the ability of an e-referral system within the HIE to capture both patient information and referral history.
"Once you have this information, you'll be able to track referrals and make sure the ones that should be going back to your hospital are," says Dr. Newman. Conversely, this technology will also aid in tracking discharges and subsequent physician follow-ups.
2. Readmission avoidance. The ability to track patients over time will also help avoid readmissions, says Dr. Newman. Once nurses and physician assistants are able to see a patient's complete medical record even after the patient has been discharged and is back with a primary care physician, the providers can work together to help prevent a return visit to the hospital.
HIEs will be a "big help" in this area, says Dr. Newman.
3. Accountable care organization support. According to a recent survey by eClinicalWorks, 95 percent of organizations participating in an ACO believe integrated electronic health records are the most important technology for improving patient outcomes and achieving ACO success.
EHRs are even more valuable when connected throughout the health system, says Dr. Newman. "If you're transitioning to an ACO model, you need to start thinking of ways to transfer information within the system to both improve quality of care and improve things on the financial side," he says.
Systemwide HIEs help in this regard because they allow systems to track a patient and ensure care quality at every step. "Under an ACO, you're really responsible for the patient," says Dr. Newman. "HIEs help you manage this responsibility."
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