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Health information exchange is improving health care quality, safety, and patient outcomes by allowing healthcare providers to access and share medical information electronically. Texas Health Services Authority was created to help support and improve the Texas health care system by promoting and coordinating health information exchange (HIE) and health information technology (HIT) statewide. Today many patients are receiving care based on incomplete medical records which can be harmful. With HIE connectivity, the provider will have the patients’ health information to ensure patients are receiving the right care, from the right health care providers, at the right time (THSA, 2019).
Health Information Exchange (HIE) is the secure electronic exchange of all patient’s clinical and administrative information within a region, community and internationally between different systems (Ahmadi, Nasiri, & Sadoughi, 2018). Moreover, physicians and health care staff need to have timely access to patient information that is gathered and considered crucial in decision-making. Not having this information can lead to reducing the level of quality and unnecessary costs. HIE has the potential to help with solutions to problems related to non-interoperable issues. The main objective is to have precise and perfect medical records to transmit and share among organizations such as drug list, laboratory, radiology, procedure reports, and discharge summaries. This helps the provider to make informed decisions and prevent medical errors.
Despite the possibilities of the HIE, evidence has shown that the effect of healthcare quality, efficiency, safety, and cost have been inconsistent (Ahmadi et al., 2018). Some of the issues associated with HIE are technical limitations, financial constraints, lack of interoperability, privacy, and security concerns. There are several stakeholders in healthcare, from producers and users, but the most precarious is the consumer. Their consent is required for the sharing of health information. Even though consumers support the benefits of HIE, their main concerns are privacy and security, such as having unauthorized disclosure of personal information.
The Texas Health Services Authority (THSA) was created in 2007 by the Texas Legislature as a public-private partnership, nonprofit cooperation (THSA, 2019). The THSA board of directors are appointed by the governor to overlook the development of HIE Texas. It was formed under the Texas Health and Safety code to promote, implement, and facilitate the exchange of health information in the state of Texas. A local network, a set of shared services made available known as HIETexas. One of the most compelling benefits, HIETexas not only has authorized connectivity in Texas but across the country (THSA, 2019). Therefore, local HIEs in Texas can connect to many data sources across the state and the nation through the eHealth Exchange. HIETexas is one of the 110 participants of eHealth Exchange. Another benefit, still in the early stages, is Integrated Care Collaboration (ICC), a HIETexas participant has the ability to respond to requests from participants outside of Texas.
With the interoperability of electronic health, information increasing comes privacy and security responsibilities. THSA is proud to offer its users SECURETexas certification to covered identities that are compliant with Texas and federal privacy and security laws. Therefore, a covered entity is any organization who uses, stores, or exchanges health information, as defined by Texas Medical Records Act and would benefit from certification.
To better understand the findings, future research and studies need to be done to examine providers’ and patients’ perceptiveness on the effectiveness of HIE, as the adoption process has been slow. For instance, research by Ahmadi et al. (2018) indicated that only 10% of U.S. hospitals had applied HIE and other studies show that 30% of hospitals and 10% ambulatory settings have participated in the health information exchange in the U.S. More importantly, patient’s views and perceptions of HIE is crucial as it will determine the future of health information systems (Esmaeilzadeh, & Sambasivan, 2017).
For now, there may not be strong evidence showing the effectiveness of HIE. At the same time, THSA is continuing to promote growth and adoption through HIETexas. Local HIEs have connectivity to one another, increasing the connection across the state and the nation. It is crucial to continue to monitor and study the health information exchange to demonstrate the benefits and address concerns to the clinician and consumer.
- Esmaeilzadeh, P., & Sambasivan, M. (2017). Patients' support for health information exchange: A literature review and classification of key factors. BMC Medical Informatics and Decision Making, 17(1), 33. https://doi:10.1186/s12911-017-0436-2
- Sadoughi, F., Nasiri, S., & Ahmadi, H. (2018). The impact of health information exchange on healthcare quality and cost-effectiveness: A systematic literature review. Computer Methods and Programs in Biomedicine, 161, 209-232. https://doi-org.libproxy.txstate.edu/10.1016/j.cmpb.2018.04.023
- THSA The Authority for HIE and HIT. (2019). Understanding HIETexas: THSA provides significant benefits, expanded connectivity to local HIEs. Retrieved from https://www.thsa.org/newsletter/understanding-hietexas-thsa-provides-significant-benefits-expanded-connectivity-to-local-hies/
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