Promise of health information exchanges for public health

As a result of the passage of the HITECH Act in 2009, individual states as well as Federal agencies have dramatically accelerated the adoption of electronic exchanges of health information. The primary purpose of health information exchanges (HIEs) is typically to improve the coordination of care, but there are substantial opportunities for secondary use of this data for public health purposes. HIEs can be a rich trove of highly computable data about episodes of care, and often include detailed information about patient demographics, diagnoses, procedures, medications, allergies, problem lists and more. However, there are also important challenges to utilizing this data for public health purposes. Specific concerns include protection of patient privacy rights, and technical approaches to integrating HIE data sources into public health systems for biosurveillance and other purposes. In this session, panelists will discuss several aspects of working with HIEs to support public health objectives. Specific topics to be covered include: 1) Understanding the evolution of HIEs and their primary missions; 2) Clinical data typically collected by HIEs, including the relevant health informatics standards utilized; 3) The two dominant architectures utilized nationally for health information exchange, and the related public health systems integration strategies; 4) Issues associated with patient privacy and data de-identification strategies; and 5) Potential applications of HIE data for public health purposes.