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Informatics > Health Information Exchange > Flashcards

Health Information Exchange Flashcards

1
Q

Health information exchange

A
  • critical element of meaningful use (MU)
  • integral to future success of healthcare reform
  • important to all healthcare organizations and insurance companies
  • disability process continuity of medical care issues
  • bio-surveillance
  • research and natural disaster repsonses
  • clinical results, images and documents, financial and administrative data
  • interoperability is a key
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2
Q

MU-meaningful use

A
  • Meaningful Use was defined by the use of certified EHR technology in a meaningful manner (for example electronic prescribing); ensuring that the certified EHR technology connects in a manner that provides for the electronic exchange of health information to improve the quality of care. By using certified EHR technology, the provider must submit to the Secretary of Health & Human Services (HHS) information on the quality of care and other measures. The concept of meaningful use rested on the five pillars of health outcomes policy priorities, namely:
  • Improving quality, safety, efficiency, and reducing health disparities
  • Engage patients and families in their health* -> mental health
  • Improve care coordination
  • Improve population and public health
  • Ensure adequate privacy and security protection for personal health information
  • do the right thing and improve outcomes
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3
Q

Common types of health related data exchanged: clinical results

A

-lab, pathology, medication, allergies, immunization and microbiology data

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4
Q

Common types of health related data exchanged:

images

A
  • images radiology reports; scanned images of paper documentation
  • DICOM
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5
Q

Common types of health related data exchanged: clinical summaries

A

-documents office notes, discharge notes, emergency room notes

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6
Q

Common types of health related data exchanged: documents

A

-continuity of care documents (CCDs), personal health records extracts

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7
Q

Common types of health related data exchanged: financial information

A

-claims data, eligibility checks

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8
Q

Common types of health related data exchanged: medication data

A

-electronic prescription, formulary status, history

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9
Q

Common types of health related data exchanged: performance data

A

-quality measures like blood pressure, cholesterol levels

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10
Q

Common types of health related data exchanged: case management

A

management of the underserved/emergency room utilization

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11
Q

Common types of health related data exchanged: public health data

A

-infectious disease outbreak data, immunization records

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12
Q

Common types of health related data exchanged: case management

A

management of the underserved/emergency room utilization

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13
Q

Common types of health related data exchanged: referral management

A

management of referrals to specialist

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14
Q

health information exchange (HIE)

A

-electronic movement of health-related information among organization according to nationally recognized standards

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15
Q

health information organization (HIO)

A

-an organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards

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16
Q

health information service provider (HISP)

A

-an organization that provides services and support fort he electronic exchange of health information

17
Q

interoperability

A

-ability of two or more systems to exchange information

18
Q

eHealth exchange (formerly NwHIN)

A
  • network-of-networks that establishes standards, services and policies that define how HIOs will engage in the secure exchange of health information over the internet
  • stony brook, NYU langone, northwell
19
Q

opt-in and opt-out

A
  • refers to patient consent policies
  • opt in or out to sharing information
  • participating in research
20
Q

push and pull technology

A
  • push- clinicians sending (pushing) information

- pull- clinician sends an electronic request for health information to a server to perform a query

21
Q

regional extension centers (RECs)

A
  • technical assistance, best practice information, and education
  • take what someone else already did and adapt it to your hospital -> try to achieve great standards
  • advise eligible providers in all phases of the electronic health record ( EHR ) implementation cycle.
  • serves as a support and resource center to make EHR implementation easier.
22
Q

regional health information organization (RHIO)

A
  • a health information organization that brings together health care stakeholders within a defined geographic area and governs health information exchange among them for the purpose of improving health and care in that community
  • pay to give information to set up interface
  • pay to exchange information
  • ex. paying for images
  • you dont own the information
23
Q

history of nationwide health information network

A
  • 1990s-community health information networks (CHINs)
  • all failed- not enough technology
  • lack of perceived value and sustainable business plan and immature technology
  • in spite of this, raised interest in electronic health records
  • april 2004- president bush created office of national coordinator for health information technology (ONC) and at the same time calling for interoperable electronic health records within the next decade
  • ONC sent out a request for information (RFI) asking for input on how the nationwide health information network (NHIN) should be established
  • a decentralized (servers) architecture built using the internet linked by uniform communication and a software framework of open standards and policies and a network of networks
24
Q

NHIN prototype architecture

A
  • work started in 2005
  • demonstrated in 2007, highlighted issues of security, data standards and technology
  • late 2007, phase 2 (trial implementation)
  • participating organizations utilized technology known as NHIN-connect gateway
  • core capabilities tested:
  • look-up, retrieval, and secure exchange of health information
  • application of patient preferences and permissions for sharing of data
  • use of NHIN for other business purposes as authorized by consumers
25
Q

eHealth exchange

A
  • nationwiwde health information network exchange (NwHIN)
  • 2009
  • social security administration requested 15 to 20 million medical records for disability determinations
  • verification information dropped from 84 days to 46 days
  • disability/social security is granted based on medical records exchange of injury
26
Q

nationwide health information network

A
  • the set of standards, specifications and policies that enable the secure exchange of health information over the internet
  • this program provides a foundation for the exchange of health information across diverse entities, within communities and across the country, helping to achieve the goals of the HITECH act
  • nationwide health information network exchange is the first community that implemented these standards, specifications and policies in production
  • medicare and medicaid set the standards of quality, cost
27
Q

eHealth exchange and healtheWay

A
  • in 2012 the NwHIN exchange was renamed eHealth exchange
  • healtheway was created to help direct future of the NwHIN exchange
  • they believed in the product but it had a bad rep
28
Q

Blue button project*

A
  • blue button in an electronic application for a patient to download their healthcare data
  • blue button + = records in a human readable and machine readable format with the ability to send or share them
  • meets meaningful use stage 2 requirements
  • patient portals
  • patients misunderstand -> immediate gratification
29
Q

HITECH act impact on HIE

A
  • The Health Information Technology for Economic and Clinical Health Act (HITECH) is part of the American Recovery and Reinvestment Act (ARRA) of 2009 and creates incentives related to health care information technology, including incentives for the use of electronic health record (EHR) systems among providers.
  • Encouraged the growth of health information exchange through the authorization and funding
  • Supported by incorporating HIE into Meaningful Use stage 2 objectives
  • higher reimbursements based off your insurance if your using EHR and HIE data exchange
30
Q

health information organization

A
  • leverage the internet
  • build upon existing successes; take advantage of any existing infrastructure
  • have a realistic implementation plan; build incrementally or by phases or modules
  • develop strong physician involvement; involve medical schools and medical socieities
  • obtain hospital leadership commitment
  • do not exclude any stakeholders
  • seek inclusion of local public health officials
  • obtain support from the business community; vendors who have networking experience will be valuable partners
  • establish a neutral managing partner; a commission or network authority
31
Q

stakeholders

A
  • the people running around and using things on a daily basis
  • nurses technologists
32
Q

HIO functions

A
  • financing
  • regulation- what data, privacy and security standards will be used?
  • information technology- who will create and maintain the actual network? who will do the training? will the HIO use a centralized or decentralized data repository?
  • clinical process improvements- what processes will be selected to improve? will the analysis use claims data or provider patient data? who will monitor and report the progress?
  • incentives
  • public relations (PR)
  • consumer (stakeholders and patients) participation
33
Q

data exchange models: federated

A
  • decentralized approach where data is stored locally on a server at each network node (Hospital, pharmacy or lab)
  • data therefore has to be shared among the users of the HIO with an import/export scheme
  • harder to manage
  • you need administrators for each department
34
Q

data exchange models: centralized

A
  • HIO operates a central data repository that all entities must access
  • if one system goes down everything goes down
35
Q

data exchange models: hybrid

A
  • a combination of some aspects of federated and centralized model
  • doesnt serve the same function -> some centralized systems are unique/specialized
36
Q

health information exchange concerns

A
  • each HIO has a different business model
  • Long term funding
  • Will universal standards be adopted or will different standards for different HIOs prevail
  • Poor cities, states and regions tend to be at a disadvantage
  • nationwide exchange of health information with a low number of sustainable HIOs fail and incomplete adoption of EHRs?
  • Will the newest HIPAA regulations become impediments to HIO implementation and operation?
  • Opt-in and opt-out patient consent models vary
  • How to solve the patient matching and identity problem?
  • Is there a strong reason to accredit HIOs?
  • How will patient privacy and security rules under Meaningful Use

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