An HIE (health information exchange) allows medical professionals at multiple levels access and share medical information electronically, and within the confines of HIPAA privacy laws. HIE is meant to improve efficiency, speed, quality, and cost of patient care. It is thought by some in the industry that HIE is not able to address recurring challenges associated with rapid technological advancements. The initiative for HIE is being driven by meaningful use requirements, coordination needs for new payment approaches, and federal financial incentives.
While HIE has been more than twenty years in the making, it has only recently gained the majority of its support. This is because, until the recent years, HIE success has been marginal when compared to its failures and shortcomings. HIE generally started in 1990 when the Hartford Foundation began its CHMIS initiative. The was the "Community Health Management Information System" that got its start from grants to several states and cities. CHMIS provided a point of reference for data to be collected and maintained. This data provided information on demographics, clinical data, and information divided geographically. CHMIS targeted data for the stakeholders who were the primary consumers and benefactors of the data assessments. Another function of CHMIS was to facilitate billing and determine patient eligibility for cost reductions, making CHMIS a transaction system. (J Am Med Inform Assoc, 2010 )
CHMIS was a new concept, and faced many challenges that ultimately failed as a whole, but provided many learning lesson opportunities. The system was quite unaffordable, it lacked sufficient technological support, and the premise of the system caused security concerns. Lessons learned, and thus eventually passed to HIE, include the need for political support of the program initiatives and the implicit need to ensure that the assessments by the system consist of both those who are doing the measuring and those who are being measured.
Conversely, community health information networks (CHINs) were developed and implemented by individual communities who were independently interested in the concept of HIE. They were primarily commercial and had a primary initiative of cutting costs while transporting data between providers. CHINs were transaction based between each provider's independent database, as there was an objection to having a centralized data depository, which was the focus with CHMIS. Unfortunately, the capital cost of forming and running a CHIN system was unjustifiable at best and an internal competition created by the need to protect what was considered as proprietary information created its own set of challenges. Providers, vendors, and the minimizing of community-focused stakeholders created an expensive competitive base for acquiring and maintaining technology and the data distributed (J Am Med Inform Assoc, 2010 ). CHIN systems, though more widely used than CHMIS phased out in the mid...