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Unlike many data storage
systems which exist in the form of warehouse-sized servers, the HIE is
administered through a secured network over the internet. This network connects
computer systems and allows for the secured sharing of health information
between the different providers which may treat an individual patient. As a
result, when a patient is referred to a new physician, admitted to a new
hospital, or involved in an emergency, whoever treats that patient will have
immediate access to that patient’s medical records through the HIE, and the
delay of otherwise having to deliver the records are avoided.
At this point, HIE is still a
work in progress. Part of the HIE implementation strategy involved
collaboration with individual states. In an effort to bring the states on
board, the Federal Government established the State Health Information Exchange
Cooperative Agreement program. This program provides funding for the individual
states to implement technology which allows for both statewide and interstate
mobility of electronic health information.
Another dilemma in the HIE
implementation process is the issue of EMR compatibility. Being that EMR is
still an emerging technology, all EMR systems are not yet developed to a point
where there is a standardized mode of communication across different software
platforms. This would be akin to trying to communicate using different languages.
To redesign and/or rewrite the different EMR systems is sure to prove
time-consuming and costly for all involved. Furthermore, in addition to being
able to communicate across software platforms, EMR must be able to share
patient information with the HIE networks. This is done using a patient
identifier code. Like a Social Security number, the code would be issued at a
national level, and would be recognizable by all EMR systems and HIE networks.
There has been some clamor, however, surrounding the use of these
government-issued identifier codes. Some have expressed sentiments against
allowing the government control over access to these medical, for fear of
government meddling in protected health information.
As it stands, a great strides
must still be made before HIE becomes a part of everyday practice. Despite
opposition, the government continues to move forward in implementing these new
policies, and it appears as though HIE will eventually become a reality. There
are a number of predictions which attempt to forecast the point at which HIE
will come to fruition, some say two years, others say it may take up to a
decade. Until then, we will continue to trust the fax machine, the postal
service, and our colleagues to make sure medical records get where they need to
go.
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