What is Health Information Exchange (HIE)?
Think of Health Information Exchange (HIE) as a central hub of healthcare data, seamlessly connecting separate information systems to deliver the right information to the right place at the right time. HIE operates as a digital bridge spanning diverse healthcare systems for the purpose of making clinical data accessible at the point of care and promoting safe, efficient and patient-centered care tailored to each individual’s needs. Outside of the clinical context, HIE is a tool that aids stakeholders ranging from health plans assisting with care coordination needs to public health authorities in the study and improvement of population health.
The term HIE can be understood as both a verb and a noun:
- As a verb, HIE represents the electronic collection, normalization and sharing of vital health-related data across organizations, utilizing standard protocols that cater to diverse stakeholders to inform better healthcare decisions.
- As a noun, HIE refers to the organizations across the US providing these essential health information technology and services, working with regional and local communities to promote secure health data sharing.
What is a Health Data Utility?
HIEs recognize that healthcare does not exist in a vacuum, and neither should health data. Communities and healthcare providers alike understand the value of collecting health and health-related information for holistic, contextual patient care. That’s why many HIEs (the noun) are evolving into Health Data Utilities (HDUs).
HDUs are the next evolution in health information systems. They operate as advanced, statewide entities, equipped to combine, enhance and exchange electronic health data across a variety of care and service settings. Whether for treatment, care coordination, quality improvement or public and community health purposes, HDUs facilitate specific, defined use cases that have been vetted and approved by the stakeholders they serve. Moreover, HDUs prioritize patient privacy and appropriate data use, with security measures that go above and beyond the federal minimum standards established by HIPAA.
What are the benefits of Participating in the Contexture HIEs/HDUs?
Imagine a world where your health history and information are available at your healthcare provider’s fingertips, ready to guide your care. This is the promise of Contexture’s HIEs, which operate statewide in Arizona and Colorado. Contexture’s mission is to deliver comprehensive patient information quickly, securely and efficiently.
Picture being in an emergency room, unable to communicate your past medical history. With access to Contexture’s HIE, your medical providers can immediately access your profile and review your available medical history. Having such information at the point of care helps to ensure you get the best possible care. Here’s how this exciting offering benefits everyone:
- Time-saving: Quick access to patient information across systems means less time spent hunting down records and more time for providers to focus on treating you.
- Improved Care: Knowledge is power, especially when it comes to your health. A more comprehensive view of your medical history enables your healthcare team to make better decisions, reduce errors and fine-tune your treatment plan.
- Cost-Effective: HIE is designed to ensure a smooth, streamlined information flow that prevents duplicate ordering and redundant tests.
- Data Normalization and Identity Management: HIE standardizes data across systems, enabling seamless sharing among your health care providers. Contexture’s HIEs also employ best-of-breed patient matching techniques to ensure that your data is properly associated with your medical history.
- Connected Care: HIE also supports the health of the community. Connecting medical providers and public health resources enables swifter identification of communicable disease outbreaks, making our communities safer.
More information about Contexture is available here. You can find a list of Contexture participants in Colorado here and Arizona here.
Who can access patient information in the HIE?
Patient information within the HIE is securely guarded and only accessible to authorized entities – the HIE Participants – who contract with Contexture. HIE participants are bound by federal and state laws, including the Health Insurance Portability and Accountability Act (HIPAA). Moreover, they must adhere to Contexture’s stringent policies governing the proper use of patient information within the HIE.
Your care team — which may include your doctors, nurses and other healthcare providers, along with your health plan and those working on their behalf — are among the participants who can access your health information. The intent behind this access is to streamline your treatment process, coordinate care, manage cases, plan transitions of care and handle payment for your treatment. This accessibility also serves broader healthcare goals such as conducting quality assessment and improvement activities, developing clinical guidelines and protocols, conducting patient safety activities and providing population health services.
When permitted by applicable law, certain approved entities like medical examiners and coroners, public health authorities and organ procurement organizations might access the HIE for specific purposes. These may include conducting death investigations, public health investigations and activities related to organ, eye or tissue donation and transplantation.
At Contexture, we take data privacy and security very seriously. The use of HIE is strictly governed and controlled to protect patient information and may only be used consistent with the law and our HIE Policies.
Can Health Insurance Companies see my health data?
Yes, but only under specific circumstances. Your health insurance company (Health Plan) may have access to your data through Contexture, but only if they are a participant and only for specific purposes. These include coordinating your care, managing healthcare services, and facilitating quality improvement measures.
Health insurance companies cannot use the Contexture HIEs to access your medical records for insurance underwriting purposes or to determine enrollment or eligibility for coverage.
How is my health information protected inside the HIE?
Protecting the data in the HIE is Contexture’s highest priority. Our privacy and security practices have been HITRUST certified, meaning they adhere to the highest industry standards and best practices. Our systems are monitored 24/7/365 and undergo regular third-party auditing. Only individuals who have an executed and active contract with Contexture and who have been trained on the proper use of the HIE may access the Contexture Health Information Exchanges. We manage all access through role-based controls, strict password requirements and user activity auditing. Contexture is compliant with HIPAA and other relevant legal requirements. Click here to view a list of some of the privacy and security controls Contexture takes to protect health information
Is the HIE part of a State or Federal agency?
No, Contexture is an independent, non-profit community organization. However, partnering closely with state agencies — especially those operating Medicaid, public health, and behavioral health programs — is critical to achieving our mission. Contexture works hard to help government agencies administer critical health programs while protecting individual privacy and maintaining the highest standards of security for individual health information.
The Contexture HIEs were built with over a decade of sustained state, federal and private sector investment. Contexture, like most HIEs throughout the country, is a byproduct of federal legislation. The Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 provided incentives to healthcare providers for the meaningful adoption and use of electronic health records and incentivized the use of health information exchange through 2021. In addition to key HITECH federal funding, the Contexture HIEs have been supported since their inception by our participants and members, which include hospitals, health plans and philanthropic organizations.
Contexture’s work continues to be driven and funded by a blend of public and private sector organizations. As a public-private partnership, Contexture responds to the needs of both the public and private sectors when developing technology, expanding services and conducting outreach to onboard participants.
Will I be notified if my provider participates in the HIE?
Yes, if your healthcare provider participates in the HIE, they are required to notify you during your next appointment or when you register with their practice. This “HIE Notice” details the types of information in the HIE, who can access it, the reasons for its access and your right to opt-out.
Please note, not all providers participate in the Contexture HIE. If your provider does not participate, any health information generated by them during your care will not be available in the HIE. To confirm if your provider participates in HIE, please check our list of participating providers available on the Contexture website.
Can I control who sees my health information available through the HIE?
Yes, patient choice is foundational to effective governance. Patients have the right to “opt-out” of having their information available through the Contexture HIEs. If you opt out of the HIE, then none of your data will be available to your healthcare providers in the HIE provider portal even in an emergency.
You may find more information regarding the opt-out process on Contexture’s website, click here for Colorado, and here for Arizona.
What are the downsides of opting out of the HIE?
Opting out may limit the information available to doctors and other providers involved in your care, including in case of medical emergencies. Opting out also means your healthcare provider might not have a complete view of your medical history, which can be critical for making informed care decisions.
Can I change my mind and decide to opt-out later or decide to opt back in?
Yes, you can change your decision at any time by completing an opt-out or opt-in form. For more information about Contexture’s Opt-Out processes, please visit Patient Rights – Contexture.
Is my health information shared with doctors outside of my state?
Absolutely, but always with your best interest in mind and within strict compliance standards. Contexture is part of two extensive, trusted exchange networks: the eHealth Exchange (eHx) and the Patient-Centered Data Home (PCDH). Their prime objective is to facilitate seamless and efficient health information exchange nationwide, elevate patient care and bolster public health endeavors.
The eHx, pioneered by the federal government in 2006, knits together an impressive array of healthcare entities. This includes 61 regional/state HIEs, four federal agencies and a significant proportion of hospitals, medical groups, dialysis centers and pharmacies.
On the other hand, PCDH stands as a robust collaborative effort involving over 45 trusted community health information exchanges. These exchanges are pivotal, delivering critical alerts to medical providers about millions of clinical encounters every month. The PCDH operates under the diligent oversight of its Governance Council.
What happens when Contexture receives a completed opt-out form?
Contexture will process opt-out forms within 30 days of receipt. Once a patient is opted out of the HIE, their protected health information is no longer available to authorized users in the HIE portal.
How can I obtain a copy of my medical records from the HIE?
Under federal laws, including HIPAA, individuals have a general right to access their health information. Since Contexture does not have a direct relationship with the patients whose information is shared through the HIE, we depend on our HIE participants to manage requests from patients to access their data available in the HIE. Accordingly, to request a copy of your health information, please contact your healthcare provider and follow their specified process. Depending on the provider’s protocol, they may fulfill your request directly or they may direct Contexture to provide the records directly to you.
Can I request changes to my health record or other information included in the HIE?
Yes, you can request revisions and corrections to your health records by discussing with your medical provider. Contexture is not authorized to amend data in the HIE unless a participating provider directs us to do so.
Is some of my most sensitive health information provided extra protection?
Yes, certain types of health information, including substance use information, are subject to additional legal protections. All healthcare providers participating in Contexture must comply with the privacy laws and Contexture policies related to such sensitive information.
Substance use information is available through the HIE only as permitted by applicable federal law — that is, pursuant to a patient’s written consent or during a bona fide medical emergency.