Health Information Technology   Health information exchange  

Overview

Health information exchange allows authorized users to securely and electronically access and share patient health information for clinical, quality improvement, and public health purposes. Organizations providing HIE services (HIEs) support efforts to improve safety and efficiency in health care by making the right information available in the right place at the right time. HIEs range from regional, public entities (including State-Designated entities) and developers of health information technology (health IT) (e.g., electronic health record vendors) certified by the Office of the National Coordinator for Health Information Technology

Information for Health Care Consumers

Consumers benefit from understanding the electronic exchange of their health information among treating providers. The MHCC is helping raise consumer awareness and understanding of HIEs and their role in electronic data exchange. For more information, visit MHCC's HIE Consumer web page.

Nationally, there is a coordinated focus to improve access, exchange, and use of electronic health information (see the 2020-2005 Federal Health IT Strategic Plan). Federal programs and policies aiming to advance electronic health information exchange and interoperability include:

Information Blocking

Beginning in April 2021, health care providers and HIEs are prohibited from information blocking under federal regulations. Information blocking consists of certain actions that could interfere with electronic health information access or exchange by authorized users. Certain exceptions apply. More information is available here.

Centers for Medicare & Medicaid Services (CMS) Interoperability and Patient Access Rule

As of July 2021, CMS is enforcing requirements that aim to improve patient access to their health information. Under the rule, CMS-regulated payers must implement patient access and provider directory APIs, and payer to payer data exchange. More information is available here

Trusted Exchange Framework and Common Agreement (TEFCA)

Released in January 2022, TEFCA outlines a set of principles, terms, and conditions for nationwide electronic health information exchange. A voluntary network based on the Common Agreement offers a centralized model for standardized electronic health information exchange. More information is available here.

State Regulations

Maryland law (2011) requires MHCC to adopt regulations governing the privacy and security of protected health information (PHI) obtained or released through an HIE. COMAR 10.25.18, Health Information Exchanges: Privacy and Security of Protected Health Information (regulations) builds upon protections established by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended by the Health Information Technology for Economic and Clinical Health Act (HITECH) in 2009. The regulations aim to ensure privacy and security of PHI while improving access to clinical records by treating providers and supporting public health goals. The MHCC is currently aligning the regulations with leading national policies and new HIE requirements legislated in 2021 and 2022 by the Maryland General Assembly.

HIE Policy Board

The MHCC engages stakeholders with a diversity of perspectives to advise staff on policies for statewide health information exchange. The HIE Policy Board informs development of COMAR 10.25.18 relating to private and secure data exchange; consumer control over the use of and access to their health information, to the extent technically feasible; and maximizing the benefit of HIE for clinical and public health purposes.

In 2021 and 2022, the HIE Policy Board convened to deliberate on proposed draft updates to COMAR 10.25.18, aiming to align the regulations with evolving federal and state polices. For more information, visit MHCC’s HIE Policy Board web page.

State-Designated HIE

Maryland law (2009) charged MHCC and the Health Services Cost Review Commission with designating a statewide HIE, a process that occurs every three years. The State-Designated HIE is responsible for building and maintaining technical infrastructure and an efficient and effective data management strategy that can support the secure statewide exchange of electronic health information. The Chesapeake Regional Information System for our Patients (CRISP) was competitively selected to serve in this role in 2009 and has been chosen at each designation cycle based on their performance. CRISP offers a variety of tools and services to meet the needs of health care facilities, providers, patients, and State agencies.

For more information about CRISP services, click here. For historical information about HIE planning in Maryland, click here.

Quarterly Reports

CRISP reports quarterly to MHCC information on participating organizations and their utilization of HIE services. To view the most recent quarterly report, click here.

HIE Registration

Entities operating in Maryland that meet the definition of an HIE are required to register with MHCC annually, including EHR developers whose systems offer data exchange capabilities. The following HIEs are currently registered with MHCC.

For a printable list of registered HIEs, click here.

For more information, including how to register or renew registration, click here

Peer-to-Peer Learning

Health Data Utility Roundtables

In July 2021, MHCC convened state leaders and HIE representatives to discuss opportunities, challenges, and solutions to advancing electronic health information exchange. The outcome of these discussions highlighted the need and future direction for HIEs to function more broadly as a data utility to support providers, consumers, public health agencies, and payers. A resulting series of national roundtable discussions (January – April 2022) with states and HIEs was held in collaboration with Civitas Networks for Health and the Association for Health IT State Leaders

The roundtables centered on establishing and maintaining health data utilities (HDU), an advanced HIE model, providing services (regionally, statewide, or across state lines) for clinical and public health purposes. More information about the national vision for HDUs is available here. Roundtable participants included HIEs, state agencies, regional health improvement collaboratives, and other stakeholders involved in public-private health data partnerships.

Meeting Materials

January 31, 2022: Main Session Recording, Breakout #1 Recording, Breakout #2 Recording, Presentation, and Participating Organizations 

February 28, 2022: Main Session Recording, Breakout #1 Recording, Breakout #2 Recording, Presentation, and Participating Organizations

March 28, 2022: Main Session Recording, Breakout Session Recording, and Participating Organizations

April 25, 2022: Recording, Presentation, and Participating Organizations

Resources

Information on national HIE efforts and web-based interoperability training:

Office of the National Coordinator for Health Information Technology (ONC)

Information about HIE benefits and the federal vision for achieving interoperability.

Centers for Medicare and Medicaid Services (CMS)

Information about how CMS engage states to align their Medicaid programs to support HIE.

Heath Information and Management Systems Society (HIMSS)

Resource library that supports electronic information exchange to advance interoperability.

ONC Interoperability Training Courses

A five-part series of training on interoperability as it relates to the following key areas: basics training, transitions of care, lab exchange, patient and family engagement, and public health.

Contact

For more information, contact Christine Karayinopulos at christine.karayinopulos@maryland.gov


Last Updated: 6/23/2022