Reference no: EM13779828

Health information exchange

Health information exchange is the electronic movement that allows the transmission of health care-related data among facilities, health information organizations and government agencies, according to national standards for interoperability, security and confidentiality improving the speed, quality, safety and cost of patient care.

History of health information exchange

Health information exchange as a partnership development between the Heart of Birmingham teaching Primary Care Trust and the City Council, launched in July 2006, offering information, advice and collaboration over health and healthy living. Since 2008, it has been operating independently, on behalf of the community, as a social enterprise.

The remit of Health Exchange is to change the context in which health information is delivered to and accessed by all communities.

The approach is designed to move away from health as disease prevention or cure, to a perception of health as a choice that is available to and accessible by all.

Health Exchange aims to raise levels of knowledge and awareness of healthy lifestyles, by developing an intelligence delivered through a partnership with the voluntary and community sector.

In May 2008, Health information Exchange was launched as a Social Enterprise (CIC, trading as a Company Limited by Guarantee) having functioned in shadow form for the previous 2 years within the Heart of Birmingham Teaching PCT.? This meant Health Exchange became a separate company, no longer dependent on the PCT or NHS, and thus able to make independent decisions and pursue work it feels best suits the community.

In 2010, Health Exchange achieved the Matrix Standard; a national quality standard for any organization that delivers information, advice and/or guidance on learning and work. Matrix rewards for engagement, support and efficiency of service and being awarded the standard is a testimony to our commitment in developing communities and rewarding staff.

Challenges.

Technical considerations, including the use of structured data. Legacysystems and provider documentation practices (e.g., reliance on free-text fields) often result in the recording ofunstructured data. Thisscenario can complicate segmentation, which relies on the documentation of information in a structuredand codified manner that can be managed through the application of rules engines and other intelligence systems.

Defining "sensitive information."-Pre-determining categories of information can ease the implementation of segmentation - both technically andlogistically - but many patients express a strong preference for systems that enable them to convey their personal preferences more fully.

Consumer engagement.-Some approaches to segmentation would require and support deeper engagement on the part of the patient in determining and assigningsegmentation preferences.

These require consideration not onlyof the capacity of patients in this respect, but also their motivation to assume responsibility for the potentially daunting tasks associatedwith assigning and recording suchpreferences.

Provider reluctance- At present, providers play

A critical role in obtaining, documenting and honoring patient preferenceswith respect to personal health information. They also rely on the availability of accurate and relevant health information in order to provide appropriate and high-quality care. Segmentation policies must address the needs and concerns of providers as well as patients, including their concerns regarding quality and safety of the care provided,work flow implications, and liability.

Implementation of the system

Costs

Health Information Exchange is a complicated and sensitive issue where there is very little scope for errors and so the costs for implementation and utilization over longer periods of time are another problem physicians and the government is facing. The major issue as far as costs are concerned is the downtime costs which would be borne by physicians. If the HIE or EMR systems are down even for a short period of time, it can cost the physicians a lot of money and result in a drop in their revenue. As many physicians and hospitals scramble to implement Electronic Health Records to assist in the HIE process, this aspect of system downtime is sometimes ignored by system providers and health care providers as well.

Privacy

The biggest concern that physicians and patients have is the privacy of their records since there are many professionals who would have access to their health information. Since the information shared by them can be misused by many agencies such as competing insurance companies, training physicians, pharmaceutical companies and unauthorized research agencies, there certainly is a growing concern over the security of such sensitive data.

Policy issues

Health information exchange is facing a challenge with coming up having an agreement among participants in data exchange activities about the practices that will be followed to ensure that only authorized users within an institution are permitted access to protected information will give greater assurance beyond what protections technology provides regarding the security of data when it leaves the originating entity. Coming up with policies that will reduce violation of organizational policy or from outsiders who break into an organization's computer system.

systemic concerns-refers to the open disclosure of patient-identifiable health information to parties that may act against the interests of the specific patient or may otherwise be perceived as invading a patient's privacy

Public attitude -the public have not yet to understand the importance of health information exchange they see the exchange of personal information and fear their healthy information being known by other people and prefer the information be stored in book directory thus this big challenge in implementing the health information exchange.

Legal Implications

The utilization of HIE can have legal implications for small providers of EHR systems but larger government sponsored providers face lesser risks in the form of legal actions. Moreover, physicians and hospitals may face legal penalties if the system is not used in an appropriate manner which can lead to reduced quality of patient care. The legislation regarding HIE and EMRs or EHR is still being developed and this uncertainty and lack of proper regulations in the initial stages of the HIE implementation is creating anxiety among health care providers.

Benefits of health information exchange

 Improve patient safety by reducing medication and medical errors

  Increase efficiency by eliminating unnecessary paperwork and handlin;Provide caregivers with clinical decision support tools for more effective care and treatment this is because:Doctor has access to historic information that was not created by that doctor Patient is referred to a specialist, delivering electronic versions of the documents enables better care by the specialist 

  Onset of a new condition, where some prior conditions may be relevant 

  Open Referral, where the patient is allowed to choose the specialist that they go to thus making efficient for different patient to get the medication from the medical specialist they prefer. 

  The system is efficient to highly mobile patient. Either winter-summer migration, work related travel, migrant worker for their medication can be accessed from their previous medication.

  Urgent care, but not pointing that an emergency is handled as that typically as is handled through directs observation and measurement to stabilize the patient. But once the patient is stabilized there is going to need to be a record made of the treatment that the patients GP would be interested in, and there might need to be a treatment plan put in place or a referral. 

  Patient with many medical conditions- helping to keep track of the overlap between the different conditions. 

  Patient with complex condition that take many years and many treatments and many specialists have good follow up on their health records.

  Eliminate redundant or unnecessary testing- testing is done when necessary.

  Improve public health reporting and monitoring-the health reports are saved in the electronic database.

  Engage healthcare consumers regarding their own personal health information thus there is efficiency in handling the patient.

  Improve healthcare quality and outcomes-previous health treatments can be referred to and enable the doctor to offer the right treatment to the patient.

  Reduce health related costs- in this case it reduces some cost including transport incurred consulting medication.

Privacy and security

Each member details are stored in the same field thus no data loss and history of the patient medication can accessed.

Policies- Only those authorized to access and share patient data are able to do so from the records the shared information should be kept confidential; any breach should be captured and reported according to the regulations and laws.

  Use of Firewalls- a firewall is present to prevent other network users to access the confidential or personal information of a patient.

  Only authorized personnel have access to the patient information or the patient in this case.