Health Information Exchange Organizations​ Drive Interoperability Nationwide

Updated‍ January 7, 2025

Health⁤ information exchange‍ organizations (HIOs) are pivotal in enabling the electronic sharing of ‍health data among‌ health care providers, public health agencies, and payers. A recent survey‍ highlights their crucial role in promoting interoperability and ‌reveals the current​ state of health information exchange nationwide.

The survey, conducted in 2023 by the Office of‌ the Assistant Secretary for Technology policy (ASTP) in partnership wiht ⁣the⁤ University⁢ of California, ‍San Francisco (UCSF) and Civitas⁣ Networks for Health (Civitas), gathered ⁢insights from 76 HIOs ‍operating across 47 ⁢states. The findings underscore the financial challenges faced by these organizations,with only 34% reporting sufficient revenue from participants to cover operating expenses. This highlights their reliance on⁤ public support⁣ or option funding‍ models.

HIOs commonly offer services such as alerting, community health records, and parsing Clinical Document Architecture (CDA) documents. A study in Health Affairs emphasized HIOs’ unique connectivity role. ⁣In 2023, 78% of hospitals ‍participated in ⁣a regional, local, or state HIO, ⁤with some exclusively⁢ using HIOs⁢ over‍ vendor-mediated⁤ or national​ networks.The ⁢Trusted Exchange Framework and Common Agreement™ (TEFCA™) aims to ⁣establish a universal standard for nationwide health information exchange,⁢ perhaps⁢ broadening⁢ HIOs’ reach. Sixty-three percent of ​HIOs plan to participate in TEFCA,‍ while 32% remain uncertain, according ‍to the survey.

Standards adoption is​ critical ​for ‌seamless information sharing.‌ A data brief reveals​ variations ‍in standards adoption⁢ among HIOs for receiving and providing data electronically, as well as the range of United States Core Data for Interoperability (USCDI) data ⁤elements available to network members. HIOs are⁣ more likely to⁣ make USCDI data elements available⁢ but less likely to adhere to USCDI’s vocabulary standards or receive data in a​ standardized ⁤manner.

A study in JMIR Public Health highlights HIOs’‍ potential to address public health data⁢ infrastructure gaps⁣ exposed by the COVID-19 pandemic. Eighty-six percent‌ of responding HIOs‍ reported electronic connections to ⁤public health agencies⁣ (PHAs).Common‌ public health reporting functions supported by ⁢HIOs ‍include immunization registries (64%), electronic laboratory results⁤ (63%), and syndromic surveillance (61%). Furthermore, four in five⁣ HIOs make lab results available,⁤ and⁢ over half provided data ⁢to address COVID-19 information gaps, with ⁢two-thirds ‌offering data analytic services ⁤to PHAs.

Despite their contributions, HIOs face challenges. While potential information blocking ​practices by ⁣health systems and EHR vendors have decreased as prior years, 30% of HIOs still observe EHR developers engaging in such practices.​ A majority (61%)​ report that potential information blocking⁤ by developers significantly hinders their ability to⁢ provide services, while 45% cite missing data due to information blocking by⁣ health systems.

These findings underscore the active role HIOs‍ play in nationwide health information‍ exchange, offering diverse functionalities. However, policy advancements are crucial to further promote health information‌ exchange. The HTI-2 proposed rule aims to advance interoperability and‌ improve information sharing. ‌ASTP also monitors​ potential information‌ blocking practices to ensure an active information-sharing habitat.

What’s next

A new round of the national HIO survey is underway to continuously​ track the role of HIOs in health information exchange⁣ and key health ​IT policy areas. Representatives ​of HIOs or HIO executives who have ⁣not received the survey should contact Estelle Martin (Estelle.martin@ucsf.edu) to ensure their‌ organization⁣ is included.network members are encouraged to⁣ urge‍ their HIO to participate.