Electronic HIE is defined as the electronic movement of health-related information among organizations using national standards.5 The use of standards to support electronic HIE is often referred to "interoperable" HIE. HIE moves clinical information among disparate health care information systems while maintaining the integrity of the information during the exchange. Formal organizations providing HIE services are known as HIE organizations (HIEOs), Health information organizations (HIOs), or health information service providers (HISPs). HIE initiatives and activities in the United States may include participation of state, regional, and community (including private or enterprise) HIEOs or HIOs, statewide state-designated entities, health care delivery organizations, non-governmental organizations or policy/advocacy groups, academic institutions, technology vendors, public health departments, and state governments.6 HIE also occurs without the services provided by formal HIEOs, HIOs, or HISPs, such as HIE between the same electronic health record (EHR) users across non-affiliated providers, HIE between a hospital and affiliated independent physician practices, and through point-to-point exchange between non-affiliated partners (e.g., hospital to community-based SNF). The expanding reach of HIE initiatives has begun to attract and integrate new stakeholder entities such as behavioral health, home and community-based services (HCBS), aging services, other LTSS, and LTPAC providers.
For the purposes of this study and report, ASPE and the investigators considered various forms of exchange of health information, including electronically-enabled interoperable HIE, as well as more traditional forms such as paper-based approaches, fax, and telephone. Thus, the literature review and environmental scan, which examined the evidence around the exchange of information at times of transition and shared care, was not limited to electronically-enabled interoperable exchange.
5. What is Consolidated CDA? See http://www.hl7standards.com/blog/2012/03/22/consolidated-cda/, accessed March 2013.
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