The exchange of health information encompasses much more than just moving records between two systems. Health information exchange now sits at the intersection of interoperability standards, governance frameworks, compliance requirements, and the actual usability of the information in daily clinical and operational workflows.
Read on for an overview of how health information exchange functions today, and learn how organizations use exchanged data to support care delivery, operational effectiveness, and analytical capabilities.
What Health Information Exchange Means Today
HIE at its most basic is the secure electronic transfer of health information between organizations, systems, and settings. Expectations surrounding HIE have shifted over the years. Instead of assessing whether a piece of health information was successfully sent, healthcare organizations are now focused on whether it is usable when it reaches them.
Today’s priorities for HIE include:
- Timeliness of data delivery.
- Completeness of patient records.
- Accurate identity matching.
- Strong governance and access controls.
- Auditability and traceability.
- Usability within clinical workflows.
The gap between “data has been sent” and “data is useful” continues to grow, making it more vital than ever to choose the right data collection and migration services.
The Standards Behind Modern Exchange
Interoperability standards provide the basis for cross-system exchange. Healthcare environments necessarily use multiple standards, each serving a different purpose.
Interoperable standards commonly in use include:
- HL7 v2 — Standard transactional messages, such as for admission, discharge, and the availability of lab results.
- CDA (Clinical Document Architecture) — Exchange of structured documents.
- FHIR (Fast Healthcare Interoperability Resources) — For API-based, flexible access to data.
- USCDI (U.S. Core Data for Interoperability) — A standardized data model For data classes.
Following these standards reduces ambiguity and provides greater consistency. These models enhance the ability of systems to communicate with each other, and also enable the development of new and innovative ways to support healthcare delivery.
Where TEFCA Fits Into the HIE Picture
TEFCA, or Trusted Exchange Framework and Common Agreement, is an important step toward achieving interoperability among healthcare organizations across the country.
TEFCA was developed by the Office of the National Coordinator for Health IT (ONC) to provide a framework for the creation of a “network-of-networks” that enables data transfer between organizations without needing to enter into individual agreements. Essentially, TEFCA creates a more cohesive environment for exchanging health information between various types of organizations by setting rules for participation, legal and technical requirements, and additional connectivity between different types of stakeholders.
Ultimately, TEFCA enables healthcare organizations to participate in large-scale data sharing. Because it provides a common foundation for exchanging data between organizations, the fragmentation associated with previous data-sharing methods should disappear over time.
What TEFCA Does Not Solve on Its Own
While TEFCA establishes a general framework for healthcare organizations to share data, it doesn't ensure that the data is clean, complete, or useful. TEFCA doesn't resolve problems with the quality of the source data — the old "garbage in, garbage out" (GIGO) principle of computer science. Healthcare systems can still encounter poor data quality, duplicate or mismatched patient identities, and incomplete or broken records even if they follow TEFCA.
Merely sharing data isn't enough to ensure true interoperability. Healthcare organizations need to improve the quality of their internal data, strengthen data governance, and ensure that workflows are in sync to get the most out of their benefits.
Real-world Use Cases That Make Exchange Worth the Effort
Truly effective HIE makes real healthcare delivery better. It makes it easy for providers to move patients, set up referrals, and access full medical records in an emergency or after hours. It also lets providers and payers share records, helps with public-health reporting, allows patients see their own data, and lets healthcare organizations report and analyze quality.
When HIE is used for its intended purposes, it can help improve continuity of care, reduce duplicate testing, and provide greater visibility across organizations.
Why Healthcare Data Compliance Still Shapes Every Exchange Strategy
With the increase in interoperability comes greater responsibility for compliance.
Exchange strategies should consider the following:
- Role-based access controls.
- The ability to audit both access to data and data modifications.
- Minimum necessary use of data.
- Consent and governance policies.
- Accountability between vendors and networks
Healthcare data compliance is not solely about compliance with regulatory requirements, but rather building trust with stakeholders.
TEFCA supports this goal by establishing a common set of privacy and security expectations for all networks. Organizations must ensure that data remains secure, traceable, and appropriately overseen during the exchange process.
What Strong HIE Looks Like in Practice
A more mature way of exchanging health information focuses on usability rather than just connectivity, creating records that are ready for care coordination, reporting, and analytics. This is the distinction between merely moving data and making it accessible and actionable.
When you think of a strong exchange environment, consider the following characteristics:
- Interoperability based on standards.
- Framework alignment (for example, TEFCA).
- Data access is secure as well as auditable.
- Data has been validated and normalized.
- Data has longitudinal patient records across systems.
Frequently Asked Questions
What is health information exchange?
The exchange of health data is the electronic transfer of health-related information among entities, such as health insurers and medical professionals.
What is the impact of TEFCA on healthcare organizations?
TEFCA creates a consistent, well-defined structure and method for sharing health information across the U.S., helping reduce the need for individual agreements and improving the ease and efficiency of HIE.
Why is it important that HIE includes compliance with healthcare data laws?
Compliance with data privacy and security laws fosters trust among participants in health information exchange and helps meet regulatory requirements.
How does HIE impact analytics and operations?
Exchanged health data provides a more complete dataset from which to analyze patient populations, enabling improved healthcare reporting, care coordination, and strategic decision-making.
Where Hart Fits in the Exchange Conversation
Hart knows that just being connected isn't enough; healthcare organizations need usable, verified, and easily accessible data to reach their goals.
Our HealthSync™ platform is a single, long-term data repository that combines data from EHRs, laboratory information systems, medical devices, and more. It also supports standards like APIs and FHIR. By building a connected, validated, and readily accessible data foundation, organizations can enhance care coordination, compliance, and analytics.
Build a smarter, more connected healthcare data foundation with Hart today.