Section5.2 Maintain
Section 5 Maintain—Ongoing Exchange Partner Communications - 1
Ongoing Exchange Partner Communications
Health information exchange (HIE) is a relatively new concept, with different types of technology options (e.g., portal, Direct, CONNECT/HIO, others) and different HIE organizations (HIOs) in which to participate. Whether your local public health (LPH) department is just starting to explore options, is using some of the less sophisticated technology and looking to advance, or you want to make sure you are getting the most out of whatever HIE approach you are taking, communicating with the HIO and those who are participating in HIE is very important.
Time needed: 8 hoursSuggested other tools: NA
How to Use
1.On an ongoing basis, evaluate and update your goals for participating in HIE. Because HIE is new, there will be ongoing changes and additions to technologies and services available.
2.Fully identify your partners in HIE. You may be exchanging information directly with a few types of partners, such as those that refer clients to you, but there may be other partners that would benefit you.
3.Recognize the challenges faced by HIOs and to the best of your ability participate in identifying opportunities for improvement, recommending potential new services in which you would be interested, and sharing lessons learned with the HIO and your partners.
4.At a minimum, communicate with the HIO and your partners about any technical, privacy, security, or data quality issues or concerns you may have. All partners in exchanging health information must be good data stewards. For example, you may have concerns about the quality of certain data you are receiving, that a partner may have lax security practices, that an opportunity you would like to explore is being viewed competitively rather than for the good of your community, or rumors of sustainability issues at the HIO in which you participate.
Goals for Participating in HIE
As part of your planning process, you established goals and a budget for HIE. In addition to assessing the return on investment and benefits derived from participating in HIE (see 5.6 EHR and HIE Return on Investment Analysis/Benefits Realization), you should periodically reassess what is available to you against any ongoing or new needs.
The following is a checklist of services potentially offered through an HIO. No single HIO offers all of these services. Check off which ones your current HIO offers, which ones another technology or HIO in your community offers, and services that are not available but are high priority for you:
Checklist of Potential HIE/HIO Services
Potential Services (in addition to basic services of patient identification, record location, identity management, consent management, and secure transmission – see also 1.5 HIE Technology Readiness Inventory) / Current HIO Offers / Other Technology/HIO / Not Available but DesiredMost Common
Secure messaging
Hospital admission, discharge, transfer alerting, ADT
Patient summary exchange (CCD, C-CDA)
Claims processing
Immunization reporting
Emergency department visit alerting
Lab and radiology results delivery
Medical image sharing
Immunization access
Other state data reporting
E-Prescription
E-Prescribing Renewals and changes
Medication Lists
Less Common
Disease registry
Community services registry for care coordination
Biosurveillance/population health
E-Prescribing Fill Status
Eligibility verification
Prior authorization requests
Personal health record
Data/code set mapping/terminology server
De-identification and data aggregation
Data analytics
EHR hosting
Compilation of (HL7) virtual EMR
Other (specify…)
Other (specify…)
Other (specify…)
Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author
Partner Identification
Use the following tool to maintain a directory of your partners, including the types of partners available to you, if not the actual names. Describe how you currently exchange health information, what issues currently exist, and then determine other available options that would improve security, cost, productivity, speed of transmission, etc. The list of types of partners in the tool below may trigger ideas about other potential information exchange partners or HIO additions. It is advisable to document the form of written agreement you have with each partner to conduct HIE. You may want to consider formalizing some of these, especially if you have identified issues with them. A few examples are provided in italics. If you are not sure what options or other functionality is available, enter a question mark and explore further with the HIO in your community.
Use this directory to periodically update your HIE activities and to determine new services available to you.
HIE Partner Directory
HIE Partners / Exchange Type / Agreement(s) / Current Issues / Other Options or Desired FunctionalityHospitals
Community memorial / Portal / HIPAA Training / Downtime
View only
Pull / Push ADT alerts
Physician Offices
Happy Clinic / Direct / None / No alerting / ?
Dr. Jones / Encrypted email / None / Not Direct
Staff turnover
Security issues / Direct
HIO
Nursing Homes
Other Providers
Pharmacies
Health Plans
Pharmacy Benefits Managers (PBMs)
Healthcare Clearinghouses
Billing Services
HIT Vendors
State Immunization Registry
State Data Reporting Warehouse
Federal Data Reporting Warehouse
Agencies for Other Required Reporting or Compliance Requirements
Disease Registries
Community Services Registries
Personal Health Records
Other (Specify…)
Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author
For additional information on participating in HIE, see the following:
A HIMSS Guide to Participating in a Health Information Exchange, 2009, available at:
Strategic Objective 3: Identify Funding Sources and Define the Financing Strategy. This reference describes how HIOs generate revenue (and hence your potential costs) and provides links to other challenges this Beacon Community is addressing. Available at:
Copyright © 2014 Stratis Health.Updated 03-10-14
Section 5 Maintain—Ongoing Exchange Partner Communications - 1