Essay: Health information exchange (HIE)

Essay: Health information exchange (HIE)

Essay: Health information exchange (HIE)

Over twenty years of initiatives concerning health information exchange (HIE) have been taking place across the United States. However, it was not until February 2009, when the Health Information Technology for Economic and Clinical Health (HITECH) Act was signed into law, that real traction began (Winkler et al., 2016). The HITECH Act was a spark that drew movement in the way of meaningful use and electronic medical record (EMR) technology implementation across physician practices and hospitals by allocating $548 million across the United States for the development of HIE capabilities (Winkler et al., 2016). Funds were distributed through the State HIE Cooperative Agreement Program, and grantees, states, and eligible territories, were required to lay out their plan of action in how funds would be utilized to fulfill the following points of action:

Bring all privacy and security requirement up-to-date for the HIE
Launch a cohesive approach to HIE alongside state public health programs and Medicaid
Collect data showing meaningful use of HIE throughout the state
Identify disparities in HIE capabilities and create a strategic plan to fulfill the need
Guarantee alignment with national standards concerning HIE (Get the Facts about State Health Information Exchange Program, 2011).
At the beginning of this drive toward a more robust implementation and utilization of HIE, statistics showed in 2010, only 14% of hospitals and 3% of ambulatory practices were participating in any HIE entities (Winkler et al., 2016). Ultimately, the State HIE Cooperative Agreement Program provides the ability for states to continue to build into their systems and create easier methods for health information to be exchanged; this, in turn, encourages the potential for interoperability that spans across the nation.


The state of Tennessee was a grantee of the State HIE Cooperative Agreement Program and was awarded $11,664,580. There were many goals laid out by the state to encourage the growth of HIE services throughout the entire network of providers. HIE services were previously accessible through regional health information organizations (RHIOs), which are one of the initial versions of networks utilized for data sharing (Nelson & Staggers, 2019). By adding on to what was currently in place through regional initiatives, funding would be used to create an HIE system that reached beyond the region into a statewide inter-organizational exchange (Strategic and Operational Plan Profile State: Tennessee, 2009). Once statewide HIE services were established, building out a more defined system that encompassed core services, enterprise services, and value-added services was the next step. The next steps included the incorporation of Master Provider and Master Facilities Indexes to be leveraged in routing prescriptions, labs, and care records to the correction destination, fuller utilization of the electronic data interchange (EDI) for immunization registry, lab results reporting, and data collection of reportable diseases that would then be sent to the CDC (Strategic and Operational Plan Profile State: Tennessee, 2009). Other projects taken on by the state included testing on the exchange of medical records across networks for those seeking disability benefits to speed up the eligibility determination. Essay: Health information exchange (HIE)

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Tennessee had some HIE systems already in place, while some states and eligible territory that received grants from the State HIE Cooperative Agreement Program may not have had nearly the level implementation. Ultimately, no matter where each state began, this program was integral in the forward progress of the health information exchange adoption. Statistics fro 2017 show 85% of all office-based physicians utilize electronic health records, up from 2010 report of 3%, and 95% of all critical access hospitals and Medicare and Medicaid eligible hospitals have achieved meaningful use, up from 2010 reported 14% (Health IT Quick Stats, 2019). Proverbs 4:25 states, “let your eyes look directly forward, and your gaze be straight before you” (English Standard Version Bible, 2001). To reach the goals set to enhance the overall level of care, health outcomes continually, and cost-efficiency of the health care system, keeping our gaze straight ahead is required.


English Standard Version Bible. (2001). ESV Online.

Evaluation of the State HIE Cooperative Agreement Program. (2016, March).


Health IT Quick Stats. (2019, June 17).

Nelson, R., Staggers, N., (2018). Health informatics; An interprofessional approach (2nd ed.). St. Louis, Mo: Elsevier.

Strategic and Operational Plan Profile State: Tennessee. Health Information Exchange Strategic and Operational Plan Profile. (2009).

Winkler, T. J., Ozturk, P., & Brown, C. V. (2016). Sustainability strategies for regional health information organization startups. Health Policy and Technology, 5(4), 341-349.

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