Health Information Exchanges Are Valuable, but More Is Needed

Health Information Exchanges (HIEs) play a crucial role across four key domains: Public health, population health, patient and family engagement, and patient care.

The COVID-19 pandemic has vividly underscored the paramount importance of HIEs, particularly in syndromic surveillance. It has highlighted the necessity of quantifying the number of infections, severity of symptoms, and vaccination status swiftly and accurately. To effectively combat future public health threats, robust HIEs with seamless connections to public health entities will be indispensable.

In patient care, HIEs serve as vital platforms for care management, which is integral to achieving superior patient outcomes and transitioning to value-based payment models. By aggregating social determinants of health data from various providers, HIEs can identify health-related social services that enhance patients' well-being and mitigate costly downstream healthcare utilization.

Providers equipped with comprehensive data through HIEs can significantly reduce emergency department visits, hospital admissions, redundant lab tests, diagnostic imaging, and medication errors, thereby curbing associated costs. For ambulatory providers, connecting to local or regional HIEs ensures that essential clinical information is readily available at the point of care.

Although HIEs constitute an essential component of the current healthcare landscape, realizing their full potential necessitates several actions:

• Encouraging all public health agencies to contribute data to HIEs.

• Onboarding more provider offices onto HIE platforms.

• Establishing connections between HIEs and community-based organizations.

• Supporting oral health, behavioral health, and post-acute care providers in adopting electronic health records compatible with HIEs.

While most hospitals and large physician groups contribute data to HIEs, smaller provider offices encounter technical and financial obstacles hindering their data contribution. Additionally, significant data gaps exist in areas such as oral health, behavioral health, rural health, critical access hospitals, post-acute care, tribal organizations, and corrections facilities. These sectors require external funding to upgrade their charting systems for seamless data exchange with HIEs.

In the future, patients themselves will emerge as valuable data sources. Patient-reported outcomes spanning short, medium, and long-term durations will supplement data collected during office and hospital visits. With appropriate consent and trust mechanisms in place, HIEs offer an ideal platform for storing and analyzing patient-reported data.

Traditionally funded and governed by payers, hospitals, and providers, HIEs are gradually expanding to incorporate patient portals and involve patients in governance and consent processes. However, smaller provider offices and safety net clinics may require subsidies to facilitate connectivity. As public health funding increases, HIEs can be viewed as integral to public health infrastructure, delivering cost-effective social benefits.

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