A Practical Guide to Understanding HIE, Assessing Your Readiness and Selecting HIE Options in Minnesota

Plan and Select: Understanding HIE Options in Minnesota

On this page:
Minnesota’s Approach to HIE
More about the State Certification of HIE Service Providers
Do I have to use a State-Certified HIE Service Provider?
What are the State-Certified HIE Service Provider Options in Minnesota?
What other options do I have for exchanging health information?

Minnesota’s Approach to HIE

Minnesota’s approach to health information exchange is to support a market-based strategy for secure HIE that allows for private sector innovation and initiative, yet uses government oversight to ensure fair practices and compliance with state privacy protections. One role the Minnesota Department of Health (MDH) specifically has in supporting HIE is facilitating the development of technical infrastructure called shared services, which provide the services and functionality to support and promote the seamless connections between health and health care providers. These services will include provider directory solutions, consumer preference and consent repositories and record locator services. More information will be provided as these services are developed.

Another role the Minnesota Department of Health has is to certify HIE Service Providers operating in Minnesota (providing clinical meaningful use HIE transactions or services). The certification process is intended to also promote seamless connections - providers or provider organizations using any of the State-Certified HIE Service Providers could exchange health information because the certification process requires the HIE Service Provider comply with specific requirements such as: ENHAC certification; establish data sharing agreements between the State-Certified HIE Service Providers, and compliance with national standards for exchange. The statewide shared services described above will also support the secure exchange of health information and interoperability between the State-Certified HIE Service Providers.

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More about the State Certification of HIE Service Providers

In 2010, Minnesota passed a law requiring any HIE service provider offering HIE services for clinical meaningful transactions to obtain a Certificate of Authority from the Minnesota Department of Health to operate in Minnesota. As part of this process, applicants submit a comprehensive application, participate in a public hearing, and respond to questions and/or concerns from stakeholders, including consumers, before becoming certified to operate in the state.

The intent of the oversight process is so that:

  • Fragmentation of health information is prevented and information can follow the patient across the full continuum of care.
  • HIE Service Providers properly protect patient privacy and security.
  • HIE Service Providers are adhere to nationally recognized standards.
  • Minnesota has a reliable health information exchange infrastructure in place to allow Minnesota providers and hospitals to achieve meaningful use incentives and Minnesota’s 2015 mandate for interoperable electronic health records.
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Do I have to use a State-Certified HIE Service Provider?

Using a State-Certified HIE Service Provider is recommended, but it is not required for meaningful use. However, using one does provide certain benefits not available from a non-certified organization including:
  • Transparent knowledge of services offered and that the services are in accordance with national standards.
  • The ability, over time, to exchange health information with other State-Certified HIE Service Providers, providing greater interoperability statewide.
  • The HIE Service Provider has attested its policies and procedures are in compliance with both federal and Minnesota privacy laws, and it has confirmed it has privacy and security policies and procedures in place for protecting PHI (personal health information).

The most important thing you can do is choose an HIE Service Provider, or other type of intermediary, that best suits your needs and matches your HIE priorities.

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What are the State-Certified HIE Service Provider Options in Minnesota?

In Minnesota, two types of HIE Service Providers were being certified as of July, 2013:

Health Information Organization (HIO) is a not-for-profit entity that offers a robust set of HIE options
Certified HIO: CHIC (Community Health Information Collaborative)

Health Data Intermediary (HDI) is a for-profit entity that may offer a more limited set of HIE options
Certified HDIs: Emdeon, IOD (formerly known as ApeniMED) and Surescripts


One of the best ways to learn about the different State-Certified HIE Service Providers is to talk to other provider organizations that are already using them. You can also contact them to request more information and pricing information, visit the current State-Certified HIE Service Providers webpage for contact information.

Both types of HIE Service Providers typically offer nationally recommended services available throughout many parts of the country including: 

  • Nationwide Health Information Network (NwHIN): A set of standards, services and policies to support the nationwide exchange of health information. These specifications were developed into an open-source software, called CONNECT, that organizations can use to securely link their existing health IT systems into health information exchanges. Many HIE vendors (or HIE service providers) have adapted the CONNECT software for their own needs and offer it as a service that is compatible with the federal specifications for robust HIE.
  • Direct secure messaging: Direct secure messaging refers to using a set of protocols, known as the Direct Protocols, to securely push health information to a known receiver. It is commonly described as a type of secure email between two known entities; information is exchanged by way of the actual message or an attachment to the message. This is a more simple form of HIE that is useful for providers who do not yet need the more robust options such as the ability to query for patient records from unknown locations.

The following is an example of how a provider might utilize one type of HIE service provider, an HIO, that offers more robust HIE options such as query.

HIO Scenario Patient Arrives at Emergency Room Without Critical Medical Information
A critically injured patient arrives at the emergency room without bringing essential medical information. To locate the information, the provider may send a query (through the HIO they have contracted with for HIE services) to local hospitals, pharmacies and doctors' offices who are also connected to that same HIO. These organizations’ EHRs would identify records belonging to this patient and send information back to the HIO. The HIO may respond to the provider’s initial query with a response noting which other providers in the HIO network have records for this patient, or it may send a response with the aggregated patient medical information. The provider can then review the patient’s information and provide necessary lifesaving treatment.


The following example shows how a provider might utilize another type of HIE service provider, an HDI, that offers Direct secure messaging services, a more simple form of HIE.

HDI Scenario Patient Discharged from Hospital and Sent to a Rehabilitation Center
A patient at a hospital is being discharged and sent to a rehabilitation center. The nurse identifies the care center the patient is being sent to, confirms that the care center can receive Direct messages, and compiles a secure message using the Direct protocols (that can be embedded in the hospital’s EHR system) attaching the patient care summary in standardized or PDF format. The rehabilitation center receives the message and incorporates the care summary information into their EHR (or other patient record system).  
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What other options do I have for exchanging health information?

In addition to using State-Certified HIE Service Providers to meet HIE needs, some providers are finding other standards-based ways to exchange health information directly with other providers/organizations. Alternative options might include EHR-vendor facilitated exchange, or other technology-facilitated exchange, that allow for point-to-point secure messaging within a network or affiliation of provider organizations using the same EHR system or technology. Some limitations of this type of health information exchange option are that it may be difficult to exchange information outside that system or affiliation for referrals, for instance. And, as the number of potential providers/organizations to exchange with grows, it can become cumbersome to set up unique connections each time. Being connected to a State-Certified HIE Service Provider can allow providers and provider organizations to move the clinical health information where it needs to go regardless of EHR system or affiliation and ensures greater interoperability statewide.

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Updated Thursday, July 18, 2013 at 07:55AM