With increasing push from several governments across the world, Health Information Exchanges (HIE), in one form or the other, are becoming very popular among the providers and other stakeholders.
As we know, apart from the core HIE components (like patient registries, messaging, integration platforms and interfaces, clinical functional services like e-prescribing, laboratory ordering, etc.), value added services around HIEs are catching up. Access to these services is expected to increase stakeholder involvement in care delivery, ease of operations, better quality of data and reporting.
In my opinion, HIEs throw open much bigger and novel opportunities for improvement of overall wellbeing of individuals and the community at large. With a wealth of longitudinal health data availability on HIEs, they can be leveraged well for preventive care and wellbeing initiatives (which will lower morbidity, mortality and healthcare costs significantly), and community health initiatives that will help overall wellbeing of the population. This data can also be effectively utilized for medical research, contributing greatly to evidence based medicine, better assessment of incidence, prevalence and causative analysis on certain diseases, among others.
I would like to highlight the following three preventive and community health initiatives that the RHIOs and government bodies contemplating HIEs should actively consider and invest in upfront as value added services.
1) Disease Management - HIEs can contribute significantly to disease management in a population. The information available in HIE can help identify the population subset that has health conditions where self-care efforts significantly influence the outcome (e.g., Diabetes Mellitus) and help address the coordinated interventions and communications needs of that population in a better and efficient way. This way a lot of complications arising out of the chronic conditions that typically respond well to the self-care initiatives can be prevented. Though some of the health insurance agencies have started looking at HIEs to help them with their Disease Management programs, I think that, till this concept gets acceptance from all the other stakeholders, including providers, other payers and the government, it will be a difficult task. But once a couple of HIEs implement this concept successfully, it will not take much time for others to get on board.
2) Population based health management and reporting - HIEs can help assess the health care needs of the whole community that it serves. This would help the healthcare authorities to design appropriate preventive, curative, and surveillance programs that are more precisely targeted towards community needs. This will save a lot of unnecessary spending on community health initiatives in addition to achieving better health among the population. As I see it, given the fact that governments in most of the developed and developing countries are turning to HIE concepts in one or the other way, HIE enabled population based health management and reporting is not far.
3) Community wide quality reporting - HIEs can also contribute significantly in improving the care standards and quality of delivery. Through community-wide quality of care delivery reporting that is possible by the outcomes study on the information available with HIEs, one can better quantify the quality of care delivered. This can help in taking steps to prevent common medication errors, common errors of clinical judgment, in improving procedure utilization rates, and nosocomial (in hospital) mortality and morbidity within care delivery settings, among the members of HIEs. This can also contribute to better assess the impact of various measures taken to improve the quality of care in a given population.
Overall, as we can see, more and more HIE governing bodies are considering the value added services to enhance their appeal to the stakeholders. As these HIEs are going to play very crucial role in national health strategies in most of the countries, it is all the more important to get the priorities right when it comes to choosing among various components, as these have the potential to play a much larger role in the longer interest of the healthcare evolution.