Health Information Technology   Health information exchange  

Overview

Health information exchange (HIE) enables a broad spectrum of authorized users to securely share and access patient health information electronically. Enactment of the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 expanded development of the critical infrastructure necessary for electronic information exchange. Today, HIEs range from regional, public entities (including State-Designated entities) to enterprise-wide (health systems) and vendor-mediated exchange (electronic health record systems with HIE functionality). HIEs support State and federal efforts to improve quality, safety, and efficiency in health care by making the right information available in the right place at the right time. 

Post-HITECH, standards and services exist to support electronic information exchange in health care; however, exchange is often limited between one care setting and another. In January 2018, the Office of the National Coordinator for Health Information Technology released the Trusted Exchange Framework and Common Agreement (TEFCA) draft, which builds upon the significant work done by the health care industry over the last decade. TEFCA aims to advance nationwide interoperability through a set of principles designed to facilitate trust among authorized participants, and complement emerging national frameworks that support exchange across multiple networks. A key goal is to enable providers, hospitals, and other stakeholders to exchange data across organizational boundaries. Other goals center on improving patient access to their data and encouraging population-level data exchange.

State-Designated HIE

Maryland law (2009) charged MHCC and the Health Services Cost Review Commission (HSCRC) with the designation of a statewide HIE. The Chesapeake Regional Information System for our Patients (CRISP) was competitively selected to build and maintain the technical infrastructure to support secure electronic information exchange statewide. State-Designation occurs every three years to ensure CRISP can continue meeting the founding principles for HIE in Maryland, as well as further advance the technical HIE infrastructure in alignment with evolving federal policy. CRISP provides a variety of tools and services to meet the needs of health care stakeholders, such as direct messaging, patient encounter notifications, data analytics and reporting, and the Prescription Drug Monitoring Program. For more information about CRISP, click here. For more 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. For more information, click here.

Law and 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 (effective March 17, 2014) aims to ensure privacy and security of PHI accessed, used, or disclosed through an HIE; improve access to clinical records by treating providers; and support public health goals through permitted secondary use of data (e.g., research). The regulations increase privacy and security protections established by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended by the HITECH.

Registration

Existing law requires entities operating in Maryland that meet the definition of an HIE to register with MHCC annually. There are currently ten HIEs registered with MHCC. For more information, including how to register or renew registration, click here.

HIE Policy Board

The MHCC develops recommendations for HIE in the State taking into consideration diverse perspectives shared by an HIE Policy Board, a stakeholder advisory group. For more information about the HIE Policy Board, click here.

Resources

The following provides more information about national HIE efforts and web-based training on interoperability:

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)

Engage industry leaders to develop tools that support electronic information exchange and advance interoperability.

ONC Interoperability Training Courses

A five-part series of training modules that provide real-world examples and a story-based approach to 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 Alana Sutherland by phone 410-764-3330 or email at alana.sutherland@maryland.gov.


Last Updated: 4/30/2020