HIE Use Case Library

HIEs efficiently store patients health care information digitally and securely shares the information among physicians, nurses, and other health care providers in a timely manner.

HIE utilization may improve patient care coordination and transitions of care by allowing access to patients' most recent test results, procedures, diagnosis, medications, allergies and more.

HealtheParadigm is a physician-led HIE delivered in partnership with the Medical Association of Georgia and a member of the KAMMCO Network. KAMMCO offers interoperability and analytics products and services in seven states to include Kansas, Georgia, South Carolina, Connecticut, New Jersey, Missouri, and Louisiana. Use cases are developed based upon information provided by HIE participants in these states.

ORGANIZATION PROFILE:

Behavioral Health Organization established in 1961.

Organization Type: Quasi-municipality.

Services: Mental health therapy and services, 24/7 crisis programs.

Service Base: 250,000+ regional with four locations.

HEALTH INFORMATION EXCHANGE USE:

Medication history: Review prescribed medications to determine future course. It is easy to research patients and validate whether another provider has prescribed a medication. Protection for the provider and the patient.

Avoid duplicative testing: Helpful in verifying recent test results, including expensive procedures such as CAT scans.

Treatment and management: Health care providers can quickly access their patients' data across disparate health care systems, reducing treatment delays and enhancing clinical decision making.

Quick patient history and treatment review: A list of facilities where the patient was seen, admit and discharge dates, lab results, procedures and diagnoses, current and past medications, allergies, chief complaints, visit notes, operation notes and the patients' primary care providers.

Utilizing the health information exchange to pre-assess patients with appointments for psychotic diagnosis interviews (PDI's):

"The HIE helps us track allergies, medications, recent provider visits, and medical records. It's helpful because there are times when the patient is incapable of recalling what meds they are taking and physicians they have seen in the past." Pat Harris, LPN, 5 years

"Having access to the health information exchange helps with gathering data about our clients existing and past health histories and treatment to inform clinical decisions, coordinate care among providers. We can minimize duplicative testing and treatment and increase the efficiency of care. The overarching goal is to holistically improve the safety and quality of care our clients receive." Tracy Davies,
DNP, APRN, AGNP, PMHNP,
board certified Family Psychiatric Mental
Health Nurse Practitioner since 2004

ORGANIZATION PROFILE:

Behavioral Health Organization established in 1957.

Organization Type: 501c(3).

Services: Mental and community health services.

Service Base: 500,000+ metropolitan.

HEALTH INFORMATION EXCHANGE USE:

Treatment and management: Accessing the health information exchange (HIE) improves patient care coordination and transitions of care by allowing health care professionals to access their patients' most recent test results, procedures, diagnosis, medications, allergies and more.

Medication history and testing: HIE data may include critical patient information such as a list of facilities where the patient was seen, admit and discharge dates, lab results, procedures and diagnoses, current and past medications, allergies, chief complaint, visit notes, operation notes and the patients' primary care providers.

Utilizing the health information exchange for better case management and continuum of care:

"The HIE is integral to case management and continuum of care for both inpatient and outpatient services. We primarily use the HIE for patient discharge plans -- we are looking for encounters we didn't know about and identifiable physical or behavioral issues. We have better information regarding what's happened with the patient, and may see a pattern for intervention.

We see approximately 500 patients on a regular basis and 3,000 on an outpatient basis. The HIE is a tremendous resource."
Mary Jones, President, CEO

How Critical Access Hospitals with Clinics are using the health information exchange

ORGANIZATION PROFILE:

Community Hospital established in 1922.

Organization Type: Critical Access Hospital, 25 beds; 6 hospital-owned specialty clinics.

Services: Emergency medical, surgical, obstetrical, heart attack, stroke, level IV trauma, ICU and on site helicopter and land transport available 24/7.

Service Base: 24/7 critical access care to patients of all ages in seven counties.

HEALTH INFORMATION EXCHANGE USE:

Improve quality outcomes: Using the health information exchange to track demographics, admissions, discharges, transfers, progress notes, diagnosis and procedure coding, lab results and medications, results in a more comprehensive picture of patients.

Impact reporting measures: Patient satisfaction scores on the Clinician & Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) increased as patients indicated "provider knew important medical history."

Increase provider reimbursement: Patient satisfaction scores impact Improvement Activities for the Merit Based Incentive Payment System (MIPS) reporting, and rewards providers with incentive payments.

Utilizing the health information exchange to select and track quality measures, and report to the Centers for Medicare & Medicaid Services as part of the Quality Payment Program:

"HIE data can improve quality outcomes, impact quality measures reporting for MIPS, and result in increased provider reimbursement. Successful value-based care programs reward health care providers with incentive payments for the quality of care they deliver.

Utilizing the HIE assisted providers in earning an average increase of 5.75 percent in payer incentive dollars from claims billed in 2018."
Tara Orear, Senior Ambulatory Systems Analyst