The Opportunity for Health Information Exchanges (HIEs) to Untangle Health Records

The following is a guest blog by Monica Stout from MedicaSoft

As the government’s Meaningful Use incentive program accelerated the adoption of Electronic Health Records, it also increased the use of patient portals and PHRs to meet MU patient engagement measures. You see this today when you’re offered a portal login at your doctor appointments. Other encouraging trends developed around the same time:

  1. Studies proved that engaged patients tend to exhibit more positive health outcomes at lower costs.
  2. Interest increased among patient populations to be involved in their health and wellness, including a desire to see (and even contribute to) their electronic medical records.
  3. Technology innovations flourished to support health (wearables, health devices, applications, etc.).

Despite these trends and the relative success of MU-driven deployments, the patient portal and personal health record landscape leaves much to be desired for their primary users and audience – patients. Many of these tools were created simply to satisfy MU requirements and while they do this, they don’t completely tie together patients’ complex health histories, include data from multiple providers, or travel with the patient from visit to visit. Instead, patients have many different portals – a different one from every different provider. Who wants 10 different portals? Nobody has time for that!

Patients need help assembling a single view of their health records. HIEs are unique in that they work with many different health systems, hospitals, and providers in their regions. HIEs represent an opportunity to be a true integrator of health information between providers and their patients. This can be a regional solution now, and with efforts like the Patient Centered Data Home (PCDH), there is greater opportunity for HIEs to share data across state and regional lines, further expanding their reach and extending real benefits to patients who want their data in one place.

HIEs can leverage their unique position into a meaningful benefit for patient by first creating a single patient record or universal health record (UHR). This UHR or platform works seamlessly with PHRs. By making PHRs available to providers in their exchange, they can then share health data among every provider they link up with and the connections grow from there when you add in PCDH connections in other regions and states. Once there is a platform in place that is truly interoperable, sharing data between providers, patients can start using PHRs that have useful, relevant health data from all of their providers. HIEs can then start building in other capabilities like analytics, population health, care quality metrics, and more.

A patient’s medical journey involves multiple providers and different physical locations as their lives and health evolve. Their health information – in a single, universal health record – should evolve with them. HIEs can play a significant role in making that happen.

About Monica Stout
Monica is a HIT teleworker in Grand Rapids, Michigan by way of Washington, D.C., who has consulted at several government agencies, including the National Aeronautics Space Administration (NASA) and the U.S. Department of Veterans Affairs (VA). She’s currently the Marketing Director at MedicaSoft. Monica can be found on Twitter @MI_turnaround or @MedicaSoftLLC.

About MedicaSoft
MedicaSoft  designs, develops, delivers, and maintains EHR, PHR, and UHR software solutions and HISP services for healthcare providers and patients around the world. MedicaSoft is a proud sponsor of Healthcare Scene. For more information, visit or connect with us on Twitter @MedicaSoftLLC, Facebook, or LinkedIn.

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1 Comment

  • I’m still pretty dubious about the likelihood HIEs will be anything more than a short-term mechanism to help carry us forward.

    Aside from grant funding, I haven’t seen successful, sustainable, repeatable models that demonstrate a long-term future for HIEs. Further, I’m not sure they’ll be necessary, given the direct we’re headed with record exchange.

    While it’s true they can be the central repository for a patient’s records, in reality, that often means it’s a PHI dumping ground. And that dumping ground has disparate healthcare providers and EHR systems with wildly varying degrees of specificity/quality/etc. For it to be much more than that would require someone to essentially “curate” each patient’s data, and the only suitable options are (1) one or more of the patient’s healthcare providers, and (2) the patient, him/herself. Both options have problems.

    Unless the user experience is superior to EHR and easily exchanges the “cleaned up” patient data, you’re unlikely to get healthcare providers to use it. Many already dislike using their own EHRs. Convincing them to manage credentials for yet another system is going to be a difficult proposition. Plus, that user/provider access would add complexity to the HIE, resulting in more cost overhead for an already-unsustainable model.

    As far as patients, most simply aren’t cut out for managing their own records, at least not the heavily jargon-infused versions we have today. And, if they prove to be the best “curator” in the long run, it’s likely going to be via PHR (as a viewer on top of HIE), and again, someone’s going to have to fund and build THAT, too.

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