Health Information Exchange (HIE) Connectivity 

There are currently three key forms of health information exchange (source1 –healthIT.gov):  

1. Directed Exchange – ability to send and receive secure information electronically between care providers to support coordinated care 
2. Query-based Exchange – ability for providers to find and/or request information on a patient from other providers, often used for unplanned care 
3. Consumer Mediated Exchange – ability for patients to aggregate and control the use of their health information among providers 

• Directed exchange is used by providers to easily and securely send patient information—such as laboratory orders and results, patient referrals, immunizations or discharge summaries—directly to another health care professional.   

• • Can be implemented using PhiMail service 

• • Enable direct exchange between providers 

• • Can be used for referral, immunization, patient transfer etc. 

• Query-based Exchange is used by providers to search and discover accessible clinical sources on a patient (source 2 – Massachusetts Ehealth.org) 

• • To participate in Query HIE, a provider’s EHR vendor needs to incorporate a Query HIE Network that connects providers who are willing to exchange information via Query HIE. 

• • A Query HIE Network offers the participating providers the functionality needed for Query-based Exchange of patient health information. 

• • The more providers are connected to HIE networks, the more effective the query-based exchange network becomes.    

• • There are public and private initiatives that work on making HIE widely available to providers. The most used public initiatives include Carequality and Commonwell.   

• • Information storage – Health information is typically not stored on the Query HIE Network itself. The functionality works based on indexing, meaning that the network only knows on what EHRs and other clinical systems the information is accessible and for which patients. The information retrieval is done directly from the systems that hold the health records. Basically, the network mediates the exchange. 

• • Providers listed in Carequality’s Provider Directory can search the directory to request a patient record from any other provider listed in the directory. This directory includes all providers who use either: 

• • Carequality-enabled EHRs, or 

• • Commonwell-enabled EHRs with an activated Commonwell – Carequality Connection (explained below)  

• Consumer-mediated exchange provides patients with access to their health information, allowing them to manage their health care online in a similar fashion to how they might manage their finances through banking application. Patient portal is a main tool for consumers to view or manage their health information.  

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Reference: 

Source1 – healthIT.gov : https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/what-hie#query-based_exchange 

Source2 (published on 2019) – Massachusetts eHealth.org: https://mehi.masstech.org/query-hie-toolkit