Health Information Exchange
Health Information Exchange

What is Health Information Exchange?

The term "health information exchange" (HIE) actually encompasses two related concepts:

  • Verb: The electronic sharing of health-related information among organizations
  • Noun: An organization that provides services to enable the electronic sharing of health-related information

Why Health Information Exchange Is Important

The ability to exchange health information electronically is the foundation of efforts to improve health care quality and safety. HIE can provide:

  • The connecting point for an organized, standardized process of data exchange across statewide, regional, and local initiatives
  • The means to reduce duplication of services (resulting in lower health care costs)
  • The means to reduce operational costs by automating many administrative tasks
  • Governance and management of the data exchange process

Health Information Exchange Benefits: A Few Examples

  • Provides a vehicle for  improving quality and safety of patient care
  • Provides a basic level of interoperability among EHRs maintained by individual physicians and organizations
  • Stimulates consumer education and patients' involvement in their own health care
  • Helps public health officials meet their commitment to the community
  • Creates a potential loop for feedback between health-related research and actual practice
  • Facilitates efficient deployment of emerging technology and health care services
  • Provides the backbone of technical infrastructure for leverage by national and State-level initiatives

The Nationwide Health Information Network Exchange

The Nationwide Health Information Network Exchange is a confederation of stakeholders at the forefront of health information exchange, including Federal agencies; State, regional, and local health information organizations; integrated delivery networks, and private organizations. Through this mechanism, stakeholders are coming together to develop and implement standards, services, and policies that foster secure health information exchange over the Internet.

Learn more about the Nationwide Health Information Network Exchange.

The State Health Information Exchange Cooperative Agreement Program

To build the capacity for EHR information exchange nationwide, the Office of the National Coordinator for Health Information Technology awards grants to States, eligible territories, and qualified State-designated entities to further develop governance, policies, technical services, business operations, and financing mechanisms.

Learn more about the State Health Information Exchange Cooperative Agreement Program.


EHR Interoperability

A complex health care system requires diverse electronic health record (EHR) products. One size does not fit all. To realize their full potential, EHR products must be able to share information seamlessly. An interoperable health IT environment makes this possible.

EHR Interoperability enables better workflows and reduced ambiguity, and allows data transfer among EHR systems and health care stakeholders. Ultimately, an interoperable environment improves the delivery of health care by making the right data available at the right time to the right people.

The Office of Standards & Interoperability

To help build nationwide EHR interoperability, the Office of Standards & Interoperability (OSI) at the U.S. Department of Health and Human Services works to:

  • Encourage development of health IT standards
  • Move toward the seamless exchange of health data across all stakeholders: Federal agencies; State, local, and tribal governments; and the private sector

To achieve these goals, OSI's roles include:

  • Enabling stakeholders to come up with simple, shared solutions to common information exchange challenges
  • Curating (overseeing) a portfolio of standards, services, and policies that accelerate information exchange
  • Enforcing compliance with validated information exchange standards, services, and policies — to assure interoperability among validated systems

Where Standards Matter Most

In creating an interoperable health IT environment, standards are particularly critical in four areas of EHR technology:

  • How applications interact with users (such as e-prescribing)
  • How systems communicate with each other (such as messaging standards)
  • How information is processed and managed (such as health information exchange)
  • How consumer devices integrate with other systems and applications (such as tablet PCs) 

A First Step Toward Interoperability: The Direct Project

The Direct Project is creating a low-cost, practical mechanism for exchanging health information over the Internet. Direct makes it possible for providers to securely email information via their EHR to other trusted providers, such as specialists, pharmacies, and laboratories. The mechanism is:

  • Simple. Connects participants by allowing them to securely transmit messages in an encrypted manner.
  • Secure. Makes it easy for participants to verify that messages are complete and not tampered with en route.
  • Scalable. Achieves Internet scale without the need for a central network authority to provide sophisticated services.
  • Standards-based. Built on well-established Internet standards, commonly used for secure email communication.

The Direct Project doesn't replace other ways of exchanging information electronically. It augments them. It does replace slow, inconvenient, expensive methods of exchange (such as paper and faxes), providing a path to more advanced interoperability.

Direct Project standards and specifications are the result of an open, collaborative process involving public and private stakeholders. Pilots are underway in 2011, with completion slated for 2012.

Learn more about the Direct Project

A Work in Progress

The move toward a fully interoperable health IT environment is a work in progress, with new developments every day. It's important to keep in mind that older EHR systems may not be fully compatible with newer products. Systems that predate current standards may require installation of applications that function as translators.


Compatibility & Information Exchange

Building EHR Interoperability

Interoperability refers to the “architecture” that makes it possible for diverse electronic health record systems to work compatibly in a true information network. The Office of Standards and Interoperability at the U.S. Department of Health and Human Services coordinates efforts to facilitate interoperability and information exchange among Federal, State, regional, local, tribal, and private stakeholders.

More About Interoperability

Enabling Health Information Exchange (HIE)

The concept of health information exchange (HIE) is at the heart of efforts to demonstrate interoperability. HIE progress is well under way, not only at the Federal level but throughout the Nation.