Emergency docs make HIE recommendations

While health information exchange holds the potential to provide emergency room physicians with more complete records of patients, significant changes in practice and public policies are necessary to support a national HIE, according to recommendations made by a workgroup from the American College of Emergency Physicians (ACEP).

The recommendations, published recently in the Annals of Emergency Medicine, consist of several primary and secondary emergency medicine-focused suggestions. 

The article covers a range of issues, including different types of exchange architectures; patient matching; consent management; and access and authorization.

Among the primary recommendations, the authors say:

  • Emergency physicians must be involved in regional and federal HIE activities
  • HIE policies must be based on best practices to promote liability protection related to HIE use, including inadvertent failure to review all available data, action taken because of missing or inaccurate data, or inadvertent access of the wrong patient's data
  • Care standards and protocols for effective integration of HIE in emergency department electronic health records (EHRs) should be developed, including workflow optimizations

Secondary recommendations include:

  • More work must be done to improve patient matching both regionally and nationally, including the consideration of a national patient identifier
  • Federal and state health information exchanges should implement opt-out consent (versus opt-in), and there should be no limitations on types of data available in emergency situations, such as protected classes of information such as HIV status, psychiatric or substance abuse treatment
  • Because of the quantity of data, HIEs should ensure that they present highly summarized but comprehensive data

Using HIE data, the Kentucky Department for Medicaid Services used technology ranging from data analytics tools to geomapping software to identify 4,400 Medicaid "super-users" and steer them toward better primary care rather than the emergency room.

What's more, a University of Michigan study found that emergency departments with access to an HIE are more likely to avoid repeat imaging.

To learn more:
- read the article
- here's the announcement