The Health information exchange (HIE) is an electronic means of sending and receiving healthcare-related information among the health facilities, health information organizations as well as the governmental agencies as per the national standards. The main aim is to enable the efficient access and retrieval of data in a manner that is safe therefore improving the care quality and the safety of the patients and minimizing the cost in healthcare (Kaelber & Bates, 2007). The eHealth exchange accords that the individuals participating transfer their health information to the rest of the participating organizations, matching patients to their data without the application of the national patient identifier, thus, search and request health information copies from the other organization participating in case they are allowed by the policy and law. In ensuring health information in hospitals, there are policies such as audits, control data recovery, and security, that are implemented to cover data security. Audit trails are an essential security measure as it is a record that clearly outlines the history of people with access to the computer, time accessed and operations undertaken. This is key in tracking down the activities of the hospital employees. Control data recovery is a crucial component in the healthcare setting as it ensures that no fundamental data of the patient is lost. This facilitates the protection and storing of the data over a while and the retrieval of the same data in case of a system failure. E-security, on the other hand, is crucial for the protection of the HIE systems in the hospitals against hacking or cyber-attacks.
Systems Capabilities to Meet Regulatory Requirements
The useful application of the requirements propels the HIE initiative; coordination is required for the latest payment approaches and efforts in federal finances. HIE is significant to the US and with its organizational structures, architectures, and services, it has been successful to serve the states, regions, and local areas as expected. HIE facilitates the coordination of care, where the Agency for Healthcare Research and Quality describes the individual patient care organization activities among two or more parties involved in the care of patients to enable the correct delivery of healthcare services. This facilitated communication gives healthcare providers a whole view of the health of patients and minimizes the errors risk, repeated treatments or tests alongside readmissions, whereas increasing the safety of patients and outcomes. HIE can be applied in the population health improvement (Overhage, Evans, & Marchibroda, 2005). Healthix which is a New York-based HIE played a crucial role in the helping of the New York State Department of Health's AIDS Institute supervision and controlling of the HIV-positive population. Long term care is vital for the community; therefore Healthix identifies HIV-positive people and the care they should receive. The Health Department used that information to emphasize the initiatives on the public health surveillance that would enable the creation of links to care and the appropriate therapies to the HIV-positive people. There are several benefits accrued to patients by the HIE. A perfect example is that HIE facilitates the engagement of patients, giving patients a copy of their medication information electronically so that they can avail it to the healthcare providers. Additionally, HIE can be used in the improvement of the patient-provider exchange of information, therefore, achieving the required satisfaction in patients.
HIE Organizational Structures, Architectures, and Services
There exist three architecture types of HIE. The architecture types comprise of centralized, decentralized and hybrid (Frisse, Tang, Belsito & Overhage, 2010). The centralized models are the health information that is gathered from participants in the HIE and stored in one database. This model is best suited in social networks, and it is simple to query data. The decentralized models are the health records that are stored in different repositories. Every health provider organization sustains control and ownership of the documents in health. The health record access is enabled to the users upon the request. This model is also called the federated where the data is focused at the point of service (POS). On the other hand, the hybrid model applies a combination of both centralized and decentralized models. HIE utilizes two means of exchange of data. These include push and pull. In case the message like a laboratory result is conveyed from a participant to another, this is a push exchange whereas the pull exchange is when there is searches or queries on the health information of a patient.
Data Stewardship in HIE Services
Stewardship in the health data is a role directed by rules and practices that facilitate the knowledgeable and correct application if data retrieved from every personal health information. Health data stewardship is highly considered as practically urgent as a result of the additional electronic health data availability (Jha, Doolan, Grandt, Scott, & Bates, 2008). It has further recognized the electronic value in making health care and the population health better. It has also increased the use of communication and information technology in health care, therefore, exposing the potential hazards that relate to the incorrect health data uses. There is a broad country effort in the healthcare and information technology sector, employers, government agencies and the clients to develop and exercise the control on the country's entity in the health data stewardship. This would play a significant role in ensuring that the rules for standards are developed for standardized and data that health information technology (HIT) would facilitate the exchange of health information. The NHDSE should bring together the supporting bodies to the life cycle and the data exchange collection through electronic and other HIE systems as well as the stored data in many registers.
The Development of Information Management Plans That Support the Organization's Current and Future Strategy and Goals
In recent years, some federal laws anchoring the HIE adoption to make better the healthcare apply the personal health information address improvement have been implemented. They are also concerned with the HIE's existence for over 20 years, therefore, aims at its efforts. Its experiences also include the challenges and limitation encountered in connection to the technology. Furthermore, the lack of new strategies is an indication that HIE has no approach to the barriers. All HIE should comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The U.S Health and Human Services (HHS) department, the HIPAA secret policies provide a federal baseline that is used permanently in the entire entities across all the states in America (Arnett et al. 2014). However, it doesn't pre-empt any state laws that place greater privacy rights and exchange information exchange protections.
The Federal Government's Concept of a Nationwide Health Information Network
The nationwide health information network (NHIN) can be described as the standard sets, laws, and services that facilitate secure health information exchange on the Internet. The forum is supported by the Office of the National Coordinator (ONC) for Health Information Technology (HIT), which started in 2004. The NHIN provide a common platform for the health information exchange nationwide across the different entities. The federal agencies effectively apply the NHIN standards and services, consumers, healthcare providers, and health information exchanges to privately exchange health information at both local and national level (Safran et al., 2007). The NHIN is a basic need for achieving health information exchange nationwide with one of the aims contained in the Health Information Technology for Economic and Clinical Health (HITECH) Act. The request on data is being given out to ask the public to design proposals to the National Coordinator for Health Information Technology office making considerations on the anticipation of creating a notice as well as develop a mechanism of governance. This aid in the development of a voluntary program under which parties that enable the information exchange in electronic health information could be made valid.
Challenges Related to HIE
However, HIE has continuously faced numerous challenges as reported to the Congress in 2014. Some of the obstacles include standards that are insufficient in some places, rules variation which limits the understanding, the high cost of health information exchange and problems in the exact match of patients with their records (Shah, Vest, Lovelace & Mac McCullough, 2016). However, IT should be designed and established in a way that it encourages user workflows and goals. The technology in place should be applied appropriately by all the healthcare stakeholders in the process of providing care to the patients.
Arnett, D. K., et al. (2014). AHA/ACC/HHS strategies to enhance application of clinical practice guidelines in patients with cardiovascular disease and comorbid conditions: from the American Heart Association, American College of Cardiology, and US Department of Health and Human Services. Journal of the American College of Cardiology, 64(17), 1851-1856.
Frisse, M. E., Tang, L., Belsito, A., & Overhage, J. M. (2010). Development and use of a medication history service associated with a health information exchange: architecture and preliminary findings. In AMIA Annual Symposium Proceedings (Vol. 2010, p. 242). American Medical Informatics Association.
Jha, A. K., Doolan, D., Grandt, D., Scott, T., & Bates, D. W. (2008). The use of health information technology in seven nations. International journal of medical informatics, 77(12), 848-854. doi: 10.1016/j.ijmedinf.2008.06.007
Kaelber, D. C., & Bates, D. W. (2007). Health information exchange and patient safety. Journal of biomedical informatics, 40(6), S40-S45. doi: 10.1016/j.jbi.2007.08.011
Overhage, J. M., Evans, L., & Marchibroda, J. (2005). Communities' readiness for health information exchange: the National Landscape in 2004. Journal of the American Medical Informatics Association, 12(2), 107-112. doi: 10.1197/jamia.M1680
Safran, C., et al. (2007). Toward a national framework for the secondary use of health data: an American Medical Informatics Association White Paper. Journal of the American Medical Informatics Association, 14(1), 1-9. doi: 10.1197/jamia.M2273
Shah, G. H., Vest, J. R., Lovelace, K., & Mac McCullough, J. (2016). Local health departments' partners and challenges in electronic exchange of health information. Journal of Public Health Management and Practice, 22(Suppl 6), S44
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