How HIE policy affects volume of data exchange

Health systems' policies regarding how their health information exchange operates plays a significant role in the volume of exchanged data, according to a study in JAMIA.

The study specifically analyzed whether automatic querying of information from other organizations and requiring HIE-specific patient consent affected the volume of data exchange.

Researchers analyzed clinical summary exchanges across 11 healthcare organizations in the Northern California HIE Collaborative, a group of institutions that use Epic's Care Everywhere HIE platform.

Participants using Care Everywhere must agree to Epic's common governance standards, which includes permitting access to patient data on the HIE to other institutions. Apart from these certain standards, though, organizations have flexibility with organizational policies that configure how they engage with the HIE, according to the study, such as the automatic querying and patient consent policies the researchers studied.

Researchers found policies regarding these two elements are very influential in increasing the volume of exchanged data. Particularly, after enabling automatic record querying — where providers automatically search for patient matches at other institutions and download their clinical information before a patient encounter — exchange volume increased by 9,929 summaries per month, up from 635 summaries per month prior to enabling the capability.

Additionally, provider organizations that did not require specific consent from patients to share data for every information transaction experienced a greater increase in summaries exchanged per month, compared to ones that required patient consent

"Automatic querying and limited consent requirements are organizational HIE policy decisions that impact the volume of exchange, and ultimately the information available to providers to support optimal care," the authors concluded. "Future efforts to ensure effective HIE may need to explicitly address these factors."

The authors also mentioned Epic's "all or nothing" approach requiring Care Everywhere users comply with their general "Rules of the Road" may be an asset to increasing use of HIEs and HIE volume.

"This avoids the need for participating provider organizations to negotiate terms with every other organization in the network, which can be particularly challenging when these organizations consider each other competitors," according to the authors.

More articles on interoperability:

Health IT tip of the day: Analytics can fill the interoperability gap in healthcare 
The 'digital dystopia': 4 thoughts from AMA CEO Dr. James Madara 
AHA suggests redefining the scope of interoperability 

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