COVID-19 Underscores the Importance of HIEs

December 2020

Katie Devlin

HIEs have become pivotal in supporting public health efforts during the COVID-19 pandemic. The need to exchange health data for care coordination, reporting, and patient identification is heightened during a crisis.

HIEs have historically played a role in disaster relief efforts. For example, when large populations of patients evacuate regions where they normally receive care, due to emergent situations like wildfires and hurricanes. HIEs allow providers to access data crucial for care delivery. Similarly, HIEs have ramped up efforts to leverage existing capabilities in response to COVID.

HIEs inherently aggregate data from various locations such as labs, hospitals, and physician practices. With COVID, data such as positive test results, inpatient or ER admission alerts, and information related to underlying diagnoses have become critical for patient care. Providers can utilize state or regional HIEs to access the aforementioned information in real-time and receive a longitudinal record of the patient’s care. Additionally, HIEs are now providing de-identified information to public health authorities on the number of COVID-positive/probable patients and length of stay. As consumers, we may not realize where the data is coming from when we watch the news, but these critical capabilities and services have been in place long before COVID. Many HIEs were already providing data aggregation, alerting, and population health metrics whether through the national networks or a proprietary infrastructure.

HIEs including Indiana Health Information Exchange, Nebraska Health Information Initiative, The Health Collaborative in Ohio, and Healthix in New York, are providing digital dashboards for participants to track COVID data instantaneously. The Health Collaborative also serves as the emergency preparedness coordinator for the region to facilitate communication, promote situational awareness, and share best practices with all participants.

Earlier this year, the Centers for Medicare and Medicaid Services (CMS) announced a new requirement for hospitals to notify providers when a patient undergoes treatment for COVID. In response, HIEs such as HealtheLink in Buffalo were able to waive the requirement for consent before delivering COVID results to providers who have a treating relationship with a patient. Likewise, HealthHIE in Nevada is offering clinicians free access to its provider portal, which contains medical records for all Nevada residents.

Before April there was no ICD-10 diagnosis for COVID-19. Instead, providers documented a series of codes related to the symptoms or potential exposure to the virus, which is difficult to identify in the EHR. HIEs like Kansas Health Information Network and the normalization firm Diameter Health, have stepped up to jointly educate healthcare organizations on the new coding requirements so that information is accurately relayed to providers at the point of care.

For greater detail on the HIE response to COVID, please refer to this article in the Journal of the American Health Information Management Association (AHIMA).