A Practical Guide to Understanding HIE, Assessing Your Readiness and Selecting HIE Options in Minnesota
Throughout Minnesota and across the country, health care providers, payers, policy-makers and many other stakeholders are seeking ways to improve the quality, safety, and cost-effectiveness of health care and to increase the health status of communities. A major component of those efforts is the large-scale movement toward the use of health information technologies such as electronic health records (EHRs) and electronic health information exchange (HIE). Secure electronic movement of clinical information is becoming the standard practice in Minnesota.
If you are a health care provider, you have likely heard a lot about HIE but may not be sure of its value to your practice. Or, your interest in HIE at this point may be focused only on meeting meaningful use requirements. The reality is there is no “one-size-fits-all” answer. With the wide range of health care settings (community hospitals, clinics, long-term care facilities, dental offices, public health, etc.) and practice sizes, your options and approach may be as unique as your organization.
This guide is intended to provide an introduction to HIE and to help you better understand your choices for HIE in Minnesota. In addition, it is intended to provide you with some issues to consider as you assess your readiness to begin or expand HIE within your practice. This resource was developed by the Office of Health Information Technology at the Minnesota Department of Health, along with input from a variety of health and health care experts from across the state.
There are various definitions of HIE, but for the purposes of this guide HIE refers to the secure electronic sending and receiving of clinical health information in ways that the information can be understood by both the sender and the receiver of the information.
Different approaches to HIE exist across the country such as EHR vendor-mediated, private-mediated (such as through a private business), or public-mediated (such as through government supported HIE services). Minnesota supports a market-based strategy for secure health information exchange that allows for private sector innovation and initiative and uses government oversight to ensure fair practices and compliance with state privacy protections. For providers in Minnesota, this means you have choices to make based on what services you need and what HIE services are offered in the Minnesota HIE market including EHR vendor or private-mediated options.
The following are five key benefits to consider as you evaluate the potential for implementing HIE in your organization:
Improved Health Outcomes Including Patient Safety
As you know, there is a huge focus today on improving care outcomes and patient safety. HIE supports these efforts by enabling access to more accurate and up-to-date information on your patients, which can result in reduced medical errors and improved appropriateness and quality of care, especially during transitions of care.
Better Communication with Patients, Families, Caretakers and Third-Parties
As a health care provider you may have heard these questions:
“Why do I have to fill out this long medical history form? Don’t you know it already?”
“How does that compare to my test results three years ago?”
“We can’t believe our mom’s records haven’t followed her here. Do we really have to start all over with the tests?!”
The lack of a complete, current and accurate health record can frustrate both patients and providers. But imagine a scenario where before a patient comes into your setting, you have the patient’s health record (with appropriate consent) available electronically. This record could include the interactions with your own practice and relevant medical information including other physician visits, lab work, medications, etc. With HIE, providers and their health care partners can share relevant medical information in a uniformly-accepted way that protects the information and privacy of the patient.
Streamlined Practice Processes
How much time does your staff spend locating past test results or other information, requesting and transcribing the information, deciphering handwriting, and performing duplicate tests? The cost in time and staff frustration is clear. HIE can enable you to reduce the administrative burden on your staff because tasks that are currently conducted manually—requesting results and patient summaries, sending referrals and receiving the reports, sending prescriptions, etc.—can be handled electronically. By streamlining workflow and reducing errors, practices often see a reduction in operating costs.
Adherence to State Law
Over the last several years, Minnesota laws have helped to encourage higher rates of adoption of electronic health records and greater standardization in how information is recorded and exchanged electronically. The following are key pieces of state legislation that may affect your practice:
- Minnesota’s 2015 Interoperable Electronic Health Record (EHR) Mandate (Minnesota Stat. 62J.495): Requires that all hospitals and health care providers have an interoperable electronic health record (EHR) system by 2015. See the "Guidance for Understanding the Minnesota 2015 Interoperable EHR Mandate" for more information.
- HIE Oversight Law (Minnesota Stat. 62J.498-4982): Establishes certification requirements and oversight for organizations providing clinical meaningful use HIE transactions within Minnesota. Visit the Minnesota HIE Oversight website for more information on this law.
Interoperability is the ability of two or more systems or components to exchange information and to use the information that has been exchanged accurately, securely, and verifiably, when and where needed.
Compliance with Meaningful Use
If your practice is seeking financial incentives for achieving "meaningful use" under the Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program, it is important to know that some of the core objectives, as well as menu objective options for Stage 1 of meaningful use, involve the exchange of health information.
Report clinical quality measures (eMeasures)*
Perform test of health information exchange*
Submit immunization information**
Submit reportable lab information (eligible hospitals only)**
Submit syndromic surveillance information**
*Core: You must complete this transaction to receive the incentive payments
** Menu: You may choose one or more of these to receive the incentive payments
The HIE requirements for meaningful use are likely to increase substantially in Stages 2 and 3.
Meaningful use is the common name for the Medicaid and Medicare EHR Incentive Programs, which provides financial payments to eligible providers and hospitals that use certified health IT to meet specific objectives as specified by the program. The overall goals are to improve health in individuals and communities, improve the quality of care, and lower costs through the effective use of health IT.
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