The health information exchange between physicians is essential to ensure quality and reliable treatment. Due to the large number of medical institutions and medical personnel, the ability to get accurate information about the patient on time is a central task of the modern healthcare system. This is the main health information exchange benefit.
The US Ministry of Health has created a state-of-the-art system that provides medical staff with access to a patient’s medical information needed to treat him. The university of Pennsylvania hospital uses this approach to transfer the patient information.
Access to the network is provided to medical personnel who receive only the specific type of access they need. People who have been granted access can view patient information only during their hospital stay and for a specified period thereafter. It is a private HIE.
It is about shared access to computerized information, which contains all the basic medical information from the patient’s medical records, collected from hospitals and health insurance funds.
The health insurance funds receive daily reports on visits to hospital admissions and hospitalizations of all insured members of the fund who were discharged from hospitals on that particular day. In the future, information on discharge will be included in the general medical record of the patient in all health insurance funds.
Illustrative examples of how sharing information improves quality of care:
An elderly patient was hospitalized in a state of disorientation, unaccompanied and without a referral, amid various medical problems and illnesses. The information exchange system showed a list of permanent medications that the patient was taking. Thus, the doctors were able to continue the constant medication during hospitalization, maintain a balanced treatment and prevent the patient’s condition from getting worse.
During the examination of a 40-year-old patient in the admission department of the hospital, changes in the ECG were noted, which caused a suspicion of myocardial infarction. The information exchange system showed that the changes in the ECG were not new and did not occur as a result of an acute incident. Thus, the possibility of myocardial infarction was excluded and unnecessary hospitalization and invasive procedures (shunting) were prevented.
During the formation of the private HIE and during its implementation, great attention is paid to the protection of private information, to ensure the patient’s rights.
Logging in to the system is possible only for medical personnel using authorized access, in accordance with the profile and position in the medical institution.
Access to information is possible only during the patient’s visit to the hospital. Doctors and special officials have the right to review the information within a certain time after the patient is discharged to complete the treatment process and medical records.
Infrastructure security – there is no central database. Information is transmitted through sites connected through a separate and secure network, with central protection, encrypted according to the principles of the latest technology. The system, which has been validated by information security experts, consists of a protective shell of infrastructures that prevents system breaches and cyber attacks.
Information confidentiality – some of the medical information and information sources are classified as highly confidential:
Note: information recorded from the patient’s words by the attending physician, family doctor, or documented in sources of information that are not confidential, is not confidential and is transferred to the database like any other information.
The classification of information confidentiality and the identity of those who have the right to view it in the database is determined in accordance with the directives of the Legal Office of the Ministry of Health (under the Privacy Act, directives of the Privacy Protection Agency and the Ministry of Justice), and may change from time to time.
It is possible to log out of the network, thus, patient information becomes inaccessible in the health information exchange system.
It is possible to ask to be logged out, although this is not recommended and can significantly reduce the quality of care provided to the patient.
In order to log out the information exchange system, a request must be submitted at the health insurance department. The request will be approved within 30 days from the date of its submission.
If a patient who is out of the health information exchange network decides to return to the network, he must fill out the appropriate form at the health insurance department. In such cases, the request will also be granted within 30 days.
Logging out makes it impossible to exchange information between institutions, except for the transfer of information about hospital visits between the hospital and the health insurance fund, as is done today with paper documents.
For those who wish to leave the network, the log out is complete and cannot be conditional on a specific institution, incident or doctor. In any case of leaving the network, it will be impossible in the hospital to get acquainted with the information about the patient that exists in other sources.