The American Recovery Reinvestment Act of 2009 was created to renovate the United States and help the country move with the times like the rest of the world. The ARRA was meant to provide tax relief, increase educational opportunities, strengthen energy independence, encourage economic growth, and to upgrade health care. The Health Information Technology for Economic and Clinical Health Act was then passed as part of the ARRA. It was designed to help create and expand the use of secure and electronic health information that would be shared among different organizations that followed standards that were nationally followed.
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What is Health Information Exchange
The Health Information Technology for Economic and Clinical Health Act helped promote the health information exchange. HIE allows health information to be swapped between different organizations according to national standards. The standards were created to ensure that health care organization computer systems all had the means to exchange information. The HIE gives physicians access to view medical charts in their entirety. These are known as electronic health records. The medical charts shared can contain notes, test results, medication lists and the patient’s past medical history. This helps improve patient care by avoiding readmissions, avoid medication errors, improve diagnosis, and decrease duplicate testing. (What is HIE? 2019)
Types of HIE
HIE is arranged into three key classifications. Directed exchange, query based exchange and consumer mediated exchange. Consumer mediated exchange allows patients to collect and control the use of their health information between providers. Query based exchange allows providers to request or search for patient information from other providers. Directed exchange enables the provider to request and receive secure health information electronically to help with the care of a patient from other physicians.
There are three main kinds of health information exchange models used across the country. These models include decentralized, hybrid, and centralized. A centralized model allows a patient’s information to be gathered and stored in a data warehouse, centralized repository, or other databases. A decentralized model gives independent but also interrelated databases the ability to exchange information. It also permits other users the ability to be able to obtain this information when it is required. The hybrid model is a combination of both the centralized and decentralized models.
The health information exchange has been faced with some challenges since being implemented. There seems to be organizations that are slow to get on board with the exchange. They still do not have the capability to meet the interoperability standards. Wearable health technology and the cloud are forcing HIE to try and keep up with the forever changing technology in the world. It’s allowing non traditional health care vendors to compete with the services the HIE provides. (12 Things You Should, 2015)
Other issues for the HIE seems to be that organizations have to trust each other when it comes to sharing patient information. Organizations that are competing against other organizations tend not to want to share patient information. Patients worried about who has access to their health history tend to not be forthcoming with their health information. This issue affects their medical care. The health information exchange is also faced with having policies in place for the ownership, responsibility, antitrust, and use of limitations of the data.
There are many positive factors to a health information exchange. For patients, the health information exchange has helped with reducing unnecessary testing. It has also helped with patient education and allowing patients to be more involved in their health care. The HIE has also helped patients that have more than one physician by allowing all the physicians to share the patient’s medical record. This also eliminates extra paperwork. The HIE has helped reduce medication errors and reduce health care costs. The exchange also provides physicians with a better way to manage patients diseases. Another benefit of the health exchange is that it provides a way for the public’s health to be monitored and reported. (HIE Benefits,2017)
Clinical Terminology and Data Standards
Data standards are the policies and guidelines on common data, formats and representations. It explains how the health information will be gathered, stored, retrieved, and shared through health care applications. According to Health Information Management, vocabulary, code set and terminology represent the meaning of clinical data. Clinical terminology allows information to be shared between information systems. It gives the systems guidelines to follow so that all the systems can communicate with one another.
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Having data quality in the health information exchange is vital. It calls for health information to be accurate, consistent, and relevant. The information must also be up to date and also legal and easy to get to. The data must have the correct amount of detail and support the application. All of the data that is being asked for is required to be filled in. Another characteristic the data quality must possess is clear definitions so that anyone coming in contact with the information will understand it.
As a consumer myself, my interest in the health information exchange is the ability for my physcians to share my information. Unfortunately, my primary care physician and specialist doctors can only share information via fax. That makes things difficult for me because my primary physician has to be the one who orders any tests that I may need. Since the specialists and primary physician are from two different locations it delays my care. I always have to go through so many changes to get the tests or therapy I need.
While conducting research for this paper, I found information on the HIE in Washington, D.C. The Chesapeake Regional Information System for Our Patients, CRISP was awarded a grant in 2016. The grant was to create more services for their providers. They created a system that would alert doctors when their patients were admitted to the emergency room or hospitals. They also created a tool where they could make sure that their services were effective, safe, and given in a timely fashion. Another tool that was created for the providers was a patient care snapshot and query portal. This portal allows physicians to see what other institutions are connected with a patient, along with the patient’s recent visits, medications, and procedures.
The health information exchange will help the U.S. move with the rest of the world. It will help ensure patient safety and eliminate errors. The HIE will help reduce medical costs. It has created the ability for physicians to communicate between different electronic record platforms. Once all facilities have gotten on board with the exchange soon, everyone will find that can improve healthcare a lot.
- Sayles, N. Health Information Management Technology: An Applied Approach. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9781584265375/
- 12 Things You Should Know About Health Information Exchanges. (2016, December 29) Retrieved from https://www.himss.org/news/12-things-you-should-know-about-health-information-exchanges
- FAQ: Health Information Exchange (HIE). (2019, June 5) Retrieved June 9, 2019, from https://www.himss.org/library/health-information-exchange/FAQ
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