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What are health information exchange organizations?

The goal of health information exchange is to facilitate access to and retrieval of clinical data to provide safe, timely, efficient, effective, and equitable patient-centered care. Health information exchange organizations (HIOs) provide the capability to electronically move clinical information between disparate health care information systems while maintaining the meaning of the information being exchanged. HIOs also provide the infrastructure for secondary use of clinical data for purposes such as public health, clinical, biomedical, and consumer health informatics research as well as institution and provider quality assessment and improvement.

Most HIOs currently are regional health information organizations (RHIOs). A RHIO facilitates accessibility and exchange of health-related information on individuals for a specified, contiguous geographic area. RHIOs typically include a range of participating health care provider entities as well as other health stakeholders such as payers, laboratories and public health departments and are often managed by a board of directors comprised of representatives from each participating organization. In order for RHIOs to be established, various stakeholders have to develop consensus on what information can be shared among different participating entities. In addition, prior to exchanging information the various entities need to sign data use agreements. Because the capacity to effectively store and manage clinical data electronically is a prerequisite for participating in health information exchange, RHIOs often have programs to assist affiliated providers with health IT adoption at the institutional level.

Resources on regional health information organizations (RHIOs):

• Financial, Legal, and Organizational Approaches to Achieving Connectivity in Health Care - This is a report that was developed for the U.S. Department of Health and Human Services (HHS) and discusses Health Information Exchange and sustainability.
• A Practical Approach to RHIO Formation (PDF - 530 KB)  - Developed by dbMotion, this white paper covers lessons learned from RHIO formation. (2006)

Resources on health information exchange:

• Nationwide Health Information Network - Link to information about the National Health Information Network supported by ONC.
• State Health Information Exchange Program - Link to the State HIE Program supported by the Office of the National Coordinator for Health IT (ONC).
• State Health IT Dashboard - Developed by HIMSS, this dashboard tracks health IT initiatives throughout the country, including health information exchanges. 
• Health Information Exchange Toolkit - Developed by HIMSS, this toolkit provides additional information about HIEs. 
• HIE Toolkit - Developed by the eHealth Initiative, this toolkit provides tips and resources about HIEs.
• Health Information Exchange Projects - What Hospitals and Health Systems Need to Know  - Developed by Manatt Health Solutions for the American Hospital Association (AHA), this executive brief discusses benefits, challenges, and lessons learned for hospitals looking to implement an HIE. (2009)
• Evolution of the State Health Information Exchange   - Developed by Avalere Health the Agency for Healthcare Research and Quality (AHRQ), this report discusses State involvement in HIEs. (2006)
• Regional Health Information Organizations (PDF 700KB)  - Developed by the United Hospital Fund, this electronic brief provides information on RHIOs and RHIO policies. (2005)
• Model Policies and Procedures for Health Information Exchange (PDF - 2MB) – Developed by the  Markle Foundation, the model policies presented here establish baseline privacy protections. (2006)
• States' Role in Health Information Exchanges - A Collaborative Across Multiple Stakeholders (PDF - 761 KB)  - Developed by Deloitte Center for Health Solutions, this is a report on States' roles in HIE and stakeholder coordination.
• Staying Alive - Creating Sustainable Health Information Exchanges - Press release highlighting some of the key findings from the 2008-2010 Annual Surveys of Health Information Exchanges.