The Health information exchange is a term with at least two meanings – one refers to sharing of health data between organisations and the other is the actual structure that allows this sharing. I’ll stick with this definition (Hersh et al, 2015)
‘Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations‘.
Think of the example where a person visits their GP, has some blood tests and then goes to the specialist. The specialist might not have the results due to this type of information being retained within the primary care organisation. There is a good reason for this. In the UK we have the data protection act (1998), the outcome of the Caldicott review and also professional guidance on patient confidentiality.
Even with all of these complexities, it should be possible for two or more health information systems to exchange information. The process for creating an exchange between two healthcare systems can be costly both in terms of time and other resources. Given that there are multiple healthcare systems, there are a considerable number of interfaces that can be created.
A more elegant solution is to create an independent flexible database of health information that can interact with multiple health information systems. The principles are outlined in the video above by the company GE Healthcare. I should say at this point that any discussion about health information exchanges cannot be separated from the work of private providers. The private sector are leading the development of healthcare information exchanges.
This does mean however that some thought has to be given about how this can be translated across to the UK. This article for instance shows that in America, the discussions about health care exchanges occur in the context of an insurance based healthcare system which is distinct from the UK healthcare system.
From a UK perspective I can see there is much we can learn from the American healthcare system. At the same time, there are subtle and complex differences including drivers for change that mean lessons are not so straightforward.
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