Public Health Informatics and Health Information Exchange

Abstract

Health information exchange (HIE) describes both (1) the act of sharing of clinical and administrative health care data between interested stakeholders and (2) the actual health information technologies and systems that facilitate this sharing. There have been multiple iterations of this concept over the past three decades, starting with the Community Health Information Networks of the 1980s, the Regional Health Information Organizations of the late 1990s - early 2000s, and now the health information exchanges that exist in various forms and offer services ranging from basic connectivity to more advanced functions such as master patient indexes, provider directories, trust services, e-prescribing, and public health reporting. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 has helped to promote HIE by including HIE reporting as a Meaningful Use Stage 2 measure and funding the State HIE Cooperative Agreement Program which provides funding for a state designated entity (SDE) to plan and build HIE capacity. There are many challenges to address. Data and messaging standards are required for semantic interoperability. The complexity of information privacy and security policies and regulations increases proportionately with the number of HIE participants. Governance and sustainability are also major challenges that must be met. The future of HIE is promising. The increasing adoption of EHR systems creates a pool of electronic health data that can support public health needs, such as automated reporting for communicable diseases, predictive analysis for syndromic surveillance, and population health reporting.