Why Health Information Exchange is Important for EHR Use

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Why Health Information Exchange is Important for EHR Use

Health Information Exchange is Important for EHR Use

Electronic Health Records (EHRs) are an integral part of today’s healthcare system. Despite initial hesitation to switch to an EHR, an overwhelming majority of organizations that have made the change cannot imagine going back to paper. EHRs improve efficiency and increase reimbursements while improving patient care. As providers become more fluent with the technology, EHRs help them with decision making and influence the way a client is treated. Additionally, EHRs enable connectivity, or to use the current buzzword, interoperability.

Interoperability refers to health information technology that enables electronic health information to be easily exchanged. It lets authorized professionals access, exchange and use the health information. In our journey to transform healthcare, Health Information Exchanges (HIEs) have been established. Connecting an EHR to an HIE allows health information to flow seamlessly to the right people at the right place at the right time.

What is an HIE?

But what exactly is an HIE? Historically, when a patient visited a healthcare facility, the provider had two paths to understand the medical history of the patient:

  • Check the facility’s own EHR system for prior visit information, such as allergies, medications, procedures, etc.
  • Ask the patient to fill in any missing information not already documented.

As you know, there are several problems with this process. Not only do patients rarely remember information from prior visits, but they are seen in multiple facilities using various EHR systems, as well. Also, consider a patient who comes into the ER and is unresponsive. How would a provider find out about his or her missing information?

A Health Information Exchange addresses this issue. An HIE is a secure central repository of patient data aggregated across multiple facilities and EHR systems in the same region. The goal is to provide a holistic view of the patient’s electronic health record through a secure, standardized system. EHRs connected to an HIE can share information via the federally defined standards of CCR (Continuity of Care Record) and CCD (Continuity of Care Document). This is the standard all federally-certified EHRs must follow.

Any federally-certified EHR connected to an HIE can (if permitted) send and/or receive information between the EHR and the HIE. Thus, the provider can send and receive electronic information with any community provider also connected to the HIE.

Benefits of Health Information Exchange

Benefits of Using an EHR for Health Information Exchange

Using an HIE streamlines information and connects a practitioner to all aspects of a client’s medical history. Practitioners can receive health information from the HIE, such as a patient discharge summary from a community hospital. This information can be brought into a patient’s chart as electronic health data after it has been reviewed. Using an HIE helps facilitate coordinated patient care, enabling an organization to:

  • Save time by minimizing readmissions
  • Increase efficiency by moving away from paper and fax machines
  • Save money by avoiding duplicate testing
  • Provide clinical decision support tools to improve care and treatment
  • Minimize medication and medical errors
  • Engage consumers about their own personal health information
  • Improve healthcare quality and outcomes.

HIEs reduce the amount of time patients spend completing paperwork and briefing their providers on their medical history. This frees up more time for discussions about health concerns and treatments between the patient and provider. By saving time for patients and providers along the continuum of healthcare delivery, HIEs have the potential to both reduce costs and improve health outcomes.

Health Information Exchange Challenges

The push for nationwide interoperability and improved health data exchange have increased HIE and EHR use. In some cases, organizations have been mandated to make the adoption. But, that doesn’t mean HIE connectivity doesn’t come without challenges.

HIE and Data Security

One of the biggest concerns with HIEs is ensuring health data privacy and security are maintained throughout the entire data exchange process. Participating organizations must follow all federal and state requirements related to data security, but they still need to allow information to be exchanged freely for patient care. While information exchange between EHR systems and HIEs is HIPAA compliant, the growing number of cybersecurity attacks have piqued concern about health data security.

A 2017 Black Book survey confirmed these fears extend to patients. Patients surveyed were nervous their digital health information might be shared beyond their physician and hospital. Furthermore, they are not confident their physician will be able to keep their personal information secure. 69% felt their primary care physician “does not demonstrate enough technology prowess” to reassure them that their data is safe.

Physician Burnout

Another major challenge HIE connectivity brings to the forefront is information overload. Physicians are already experiencing burnout. Providers are further burdened with copious amounts of data flooding them, which can lead to less effective care.

While the Patients Over Paperwork initiative is promising to reduce administrative burden and physician burnout, it doesn’t fully account for the volume of data providers will be faced with.

Many providers have lamented that their EHR system is not built with an easy to use clinical workflow. Adding another step to incorporate data from an HIE is just that – another step.

Regardless of the challenges, EHRs and HIEs aren’t going away. They are a major part of the digitization of healthcare and the shift toward value based care. Learning to utilize these tools effectively will help your organization provide more streamlined, effective patient care. And, of course, we recommend working with an EHR vendor who will help you navigate this process with training, support and best practices!



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Patagonia Health Forms Partnership with EHR 2.0 to Offer Security Risk Assessment to Customers

Security Risk Assessment

Cary, NC — February 4, 2017 – Patagonia Health, Inc., a provider of a cloud- and apps-based Electronic Health Records solution, announced a new partnership with EHR 2.0, HIPAA specialists and Security Risk Analysis consultants, also of Cary, NC.  The two businesses serve similar markets and partnering will provide enhanced security and HIPAA compliance services options offered to Patagonia Health customers.


“Health departments handle a lot of sensitive patient data but have very limited budget available,” said Srini Kolathur, Director of EHR 2.0. The core objective of EHR 2.0’s services is to ensure healthcare practices secure patient data, stored in systems and used in processes, by complying with HIPAA/HITECH privacy, security, and breach rule requirements. “For EHR 2.0 it is a great opportunity to partner with Patagonia Health, who specialize in providing cloud-based EHR systems to health departments, behavioral health agencies and community health centers. We look forward to working with Patagonia Health’s to add value to overall patient data compliance at an affordable price.”


While Patagonia Health’s EHR system provides the required privacy and security measures within the patient records, there are other policies and processes that go beyond the EHR.  Identifying these areas within the health agency, and developing an internal policy will help ensure compliance.  Alongside the customer, the consulting experts of EHR 2.0 will do just that.


“Patagonia Health’s main objective is superior service.  Our goal is to have 100% customer reference ability” stated Ashok Mathur, Patagonia Health CEO.  “Offering additional and beneficial services to our customers, services that go beyond our own expertise, is prudent.”


About EHR 2.0
EHR 2.0 assist healthcare organizations and business associates develop and implement practices to secure patient data, and comply with HIPAA/HITECH regulations and Meaningful Use (MU) EHR incentive programs. EHR2.0 experts conduct Security Risk Assessments, and ensure HIPAA Compliance for Covered Entities and Business Associates.


About Patagonia Health Inc.
Patagonia Health Inc. is a healthcare software supplier that has built a cloud and apps-based software solution. The solution includes an integrated, federally-certified, Electronic Health Record (EHR), Practice Management (PM) and Billing software. The company’s mission is to solve two major barriers to EHR adoption, usability and cost, and address customers’ number one problem: billing. Patagonia Health’s one-of-a-kind apps-based system represents a paradigm shift in the EHR software industry, and its highly-intelligent solution uses sophisticated technology that is extremely easy-to-use. Innovative and unique apps provide timely data for organizations to improve workflow, streamline their operations and take their organizations to the next level. For more information, visit www.patagoniahealth.com or email info@patagoniahealth.com.

For more information, contact:
Patagonia Health Inc.
15100 Weston Parkway, Suite 204


Cary, NC 27513
Email: info@patagoniahealth.com
Phone: (919) 238.4780
Fax: (919) 238.7920

Is the value of participating in Health Information Exchange (HIE) worth it for public health departments?

HIE for Public Health Departments

Is it critical for a public health department to connect to a health information exchange (HIE)?

Over the past several years, the answer to this question has been a confused “I don’t know enough about HIEs to know.” So, what has changed? For one, EHRs, which not only compile data, but also can standardize data fields, are being implemented nationwide. For another, the Centers for Medicare and Medicaid Services (CMS) Meaningful Use Stage 3 will mandate a certain amount of data exchange between healthcare facilities in order to receive incentive payments.

In a previous blog, “Four Ways to Exchange Data with Community Providers,” we outlined four basic methods for exchanging data. This was to help local health departments determine if HIE was the best solution for their needs. If you decided that yes, HIE is the way to go, than you need to know more about HIEs. Which type of HIE should you use and how will you use it?
If you are still in the camp of confusion, probably the best place to start is the Healthcare Information and Management Systems Society (HIMSS) website. There are various types of HIEs; which type is best for you will depend on many factors, so health departments should dig deep into each option.

HIE organizations (HIOs) vary from state to state and all have many similar offerings. In addition to having the required security for data sharing, there are two ways to use HIOs: pulling patient information from other locations, such as an emergency room doctor pulling health information (e.g. allergies) of a newly admitted patient, or by pushing information out to another healthcare provider, such as delivery of clinical results (e.g. labs). Common use cases for public health departments are vast, for example reporting vaccines administered to immunization registries, sharing prenatal records with hospitals, or Syndromic surveillance of emergency department visits and hospitalizations. While sending information electronically, via a one-to-one connection is certainly possible, it is not very efficient when there is a frequent need for exchanging information.


Choosing an HIE


One key factor in choosing an HIE should be that it operates in compliance with the Nationwide Health Information Network (NwHIN). This NwHIN is a “set of standards, services, and policies that enable the secure exchange of health information over the internet.” It was funded and established by the Office of the National Coordinator for Health Information Technology (ONC) and helps enable the exchange of information across state lines, from coast to coast. So, if a patient from North Carolina is admitted for care at a hospital in California, that patient’s records can be pulled into the hospital’s EHR, by the provider, so that an appropriate treatment plan can be administered.

As the future of Health IT evolves, the advantages of an HIE connection becomes a necessity, but to implement an HIE connection takes time and money. HIMSS offers a thorough overview and checklist to help public health departments determine if the time to connect is now. And, together with the National Association of County and City Health Officials (NACCHO), HIMSS has a Public Health Toolkit that can help determine which HIE to partner with.

Four Ways to Exchange Data with Community Providers

Four Ways to Exchange Data with Community Providers: Understand Your Specific Clinic’s Needs to Find the Right Alternative

Over the past several years, and with a push from the Centers for Medicare and Medicaid Services (CMS) meaningful use Electronic Health Record (EHR) incentives program, there has been an increase in adoption of EHRs. While use of an EHR by a clinic can provide more streamlined workflows, more legible documentation, and increased amounts of structured data, the “true value of adoption of EHRs comes when there is more liquidity and good data flow” said Dr. Ross Martin, Program Director, Integrated Care Network for CRISP (MD). He adds “This is why the HITECH Act was created.”

The Health Information Technology for Economic and Clinical Health Act (HITECH Act) was signed into law to “promote the adoption and meaningful use of health information technology” as well as addressing the ”privacy and security concerns associated with the electronic transmission of health information.” So, healthcare agencies, including local health departments, need to understand their best approach to the exchange of protected health information (PHI) between healthcare providers and agencies.

There are four basic options available:

  1. Fax or electronic fax: The old fashion way. This is simply unstructured data, all paper-based, and a single point-to-point send and receive method. To help clinics, some EHR vendors will also install an electronic fax, as part of EHR, avoiding the need to print and fax. Users can simply click a button and send an electronic fax. The fax is not a structured data and thus cannot be easily integrated into a patient electronic chart.
  2. Download CCD: Federal government has defined a good standard, termed CCR (Continuity of Care Record) and CCD (Continuity of Care Document), for exchange of patient data electronically. This is the standard which all federally certified EHRs must follow.  A CCD (Continuity of Care Document) document can be downloaded from EHR and given to a patient, say, on a USB stick. The patient can take this data to another clinic and the clinic can upload it into their EHR. Though this exists, it is not efficient and is a manually intensive process.
  3. Direct Messaging: A patient record can be securely sent to another clinic via a secure Direct Messaging system. This is much like emailing a patient record but via a secure, healthcare-defined, messaging system. Direct messaging is really a way to exchange patient specific data with another federally certified EHR. This is a point to point system and replaces fax and now patient data is integrated, electronically, within a patient chart. This includes the structured data, all electronic, single point-to-point exchange. Though this costs a little bit extra, it may be the quickest and cost effective option to get going.
  4. Health Information Exchange (HIE): This is the ultimate in exchanging data and HIEs are being rolled out, state by state, across the country. As we discussed in What is Health Information Exchange and Why is it Important for EHR use?, all EHRs connected to a HIE can share information via federally defined standards of CCR and CCD. Once a clinic connects to a local state HIE then data can be exchanged (electronically) with any other clinic connected to that HIE. This avoids having the need to do point to point data exchange via direct messaging. It has all the structured data, it is all electronic exchange, and best of all, has a multi-point to multi-point exchange capability. Roll out of various states’ HIEs are in different stages of maturity and connectivity. This method is the most useful if and when a large number of clinics are connected to the local HIE. Your EHR vendor will charge you to implement an interface to the HIE but this may be the best long term solution.

Which option shall you use? The main question to ask is, what data we wish to send and to whom (hospitals, community health centers, local health departments, primary care physicians). If a large number of clinics you wish to exchange data with are connected to local HIE then that is the best solution. However, if there is lack of connectivity to your local HIE, Direct Messaging may be the best and most efficient option for now.

What is Health Information Exchange and Why is it Important for EHR use?

Electronic Health Records (EHRs) have become a very important and integral part of the healthcare system. Despite the initial hesitation to switch to the EHR, overwhelming majority of organizations which have switched to EHR cannot imagine going back to paper. EHRs improve efficiency and increase reimbursements while improving patient care. As providers become more fluent with the technology, EHRs can help physicians with decision making and influence the way a patient is treated.


In our national journey to transform healthcare, Health Information Exchange (HIE) is part of a federal EHR Meaningful Use (MU) standard. The idea is that all community providers (public health, private clinics, hospitals etc.) will connect their EHR to HIE. But what exactly is a HIE?


In a nutshell HIE is a hub which allows the relevant parties to share information electronically rather than via old fashioned paper fax. The image displayed above shows how all clinics can connect and share patient information through the HIE.


All EHRs connected to a HIE can share information via federally defined standards of CCR (Continuity of Care Record) and CCD (Continuity of Care Document). This is the standard which all federally certified EHRs must follow.


Any federally certified EHR which is connected through the HIE can (if permitted) receive/send information between the EHR and the HIE.  Thus, the provider can send and receive electronic information with any community provider which is connected to the HIE. Timely information received (e.g. a patient discharge summary from a community hospital), after review by local health department staff, can be brought into a patient’s chart as electronic data elements. This could further influence a patient’s care and:


  1. Save time by avoiding re-admissions
  2. Get away from dealing with paper and faxes
  3. Save money by avoiding duplicate testing
  4. Improve diagnoses
  5. Potentially save lives by avoiding medication errors.
  6. Improve public health

As Stage 2 of Meaningful Use gets deployed, HIEs become pivotal game changers. Without HIEs, no EHR can be interoperable and interoperability is the driving force of Stage 2 and Stage 3 MU. Therefore, no eligible provider (EP) will qualify for their stage 3 MU incentives. “Technology and data play an increasingly important role. EHRs certainly need to be connected to a Health Information Exchange” said Dr. Robin Cummings, former Medicaid Director, NC Department of Health & Human Services.


In a recent ONC news release, Karen DeSalvo, M.D., M.P.H., M.Sc., National Coordinator for health IT is quoted, “As we move beyond [EHR] adoption to a learning health system where information is available when and where it matters most, it is important to ensure greater care coordination at the community level.” To emphasize the importance of HIE’s role, the Office of the National Coordinator for Health Information Technology (ONC) granted $38 million to, in part:

  • Expand the adoption of HIE technology, tools, and services
  • Facilitate and enable the send, receive, find, and use capabilities of health information across organizational, vendor, and geographic boundaries
  • Increase the integration of health information in interoperable health IT to support care processes and decision making

If your EHR system is not federally certified meeting the interoperability requirement for certification, or is purposefully blocking the exchange of information, you will not achieve maximum benefits from the EHR or a HIE, nor will you receive the incentive payout. Challenge your vendor or find a new EHR because “we’re about two decades behind the banking industry and we’ve got to catch up. We’ve just got to do it” says Cummings.