What are HIEs?
Simply stated, Health Information Exchange (HIE) is the electronic transfer of health care information across organizations within a community, health care delivery system, or geographic region, with the objectives of improving quality and reducing cost. Initial efforts at HIE began in the 1990s with the development of Community Health Information Networks (CHINs) and Community Health Information Management Systems (CHMISs). CHINS served as technology-based information networks linking healthcare stakeholders in a community with the goal of improving care and maintaining health for people in the community , while CHIMISs are networks focused on building a data repository for use in assessing the performance of health care providers and insurance plans. Other similar initiatives included Community Health Information Partnerships (CHIPs) and strictly commercial electronic data interchange (EDI) efforts. All were aimed at providing a community-wide, common base for sharing clinical data and facilitating its use in care improvement and performance assessment.
These early initiatives evolved into larger, regionally-focused system development efforts such as the Santa Barbara County Care Data Exchange (SBCCDE) which covered Santa Barbara County (CA) and included 4 hospitals, 45 pharmacies, 2 payers (Kaiser Permanente, Blue Cross/Blue Shield of CA), 2 large lab companies and several public agencies. This modestly sized Regional Health Information Organization (RHIO) was one of the first of its kind, but unfortunately was shut down in 2007 without ever achieving productive information exchange . Still, other RHIOs grew in size and complexity, with the Bronx RHIO an example of this trend. The Bronx RHIO covered 6 hospitals with a total of over 4100 beds and also included four large, multisite CHCs, three large rehabilitation centers and the Visiting Nurse Services of New York for a total of over 10 million encounters and 20,000 births a year.
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