Nurse writing the patient's details
HealthNovember 23, 2020

What is health information exchange and how can it help nurses?

By: Sarah Handzel, BSN, RN
As the nation’s healthcare system moves away from fee-for-service care models in favor of value-based care, information and data pertaining to each and every patient must be available to all healthcare providers. Health information exchange (HIE) systems are already in place in many states, but many nurse leaders and staff members have little understanding of these services.

A recent article featured in JONA: Journal of Nursing Administration1 provides more insight into HIE, how it is used currently, and how HIE systems could be used to help facilitate the nursing process.

What is health information exchange (HIE)?

According to The Office of the National Coordinator for Health Information Technology2, HIE systems allow healthcare professionals—and patients—to freely and securely exchange a patient’s medical record electronically. As patients age and develop increasingly complex medical needs, their information must move with them throughout the healthcare system. But traditional methods of sharing information, such as telephone calls, faxes, and postal mail, are all subject to error.

HIE incorporates patient data from multiple entities into one convenient system, which has been shown to help make informed treatment decisions at the point of care while also reducing readmissions, medication errors, and duplicate testing.1 Currently, there are three forms of HIE:

  1. Directed exchange – Healthcare providers send and receive secure patient data to each other to support coordinated care.
  2. Query-based exchange – Providers find or request patient information from other healthcare providers through the HIE.
  3. Consumer-mediated exchange – Patients access and manage their online health information and control its use by healthcare providers.

Many types of patient information are available through HIE, including but not limited to demographic data, advanced care planning, health maintenance records, laboratory results and medication lists, and social determinants of health. Over the past 10 years, there has been tremendous growth in the use of HIE among healthcare practitioners. In 2013, only 38% of physician practices used HIE; by 2015, that number had grown to 82%. But the adoption of HIE in many clinical settings has been slow for several reasons. First, the types of functionalities of HIE vary greatly, and their stakeholders may have a limited scope of use for certain tasks. Also, limited funding and a lack of sustainable business models may contribute to the lack of HIE use.

Impact of health information exchange (HIE) systems

In the era of Covid-19, HIE systems have become invaluable for managing population health, and it is anticipated that this will help shift more providers to HIE use. Since HIE systems collect patient data from various sources, healthcare leaders may be able to use HIE to predict care demands and develop strategic plans for care management.

Additionally, the use of HIE can help improve the quality, safety, and efficiency of healthcare delivery nationwide. As the adoption of such systems grows, many nurses are already directly involved in the process. But to further promote the use of HIE, both staff and leadership must be engaged. In many cases, hospitals only provide HIE access to certain clinicians, but all nurses must develop an understanding of HIE and learn to use the data it provides to enhance patient care.

Nurse leaders and care coordinators must also help operationalize the use of HIE so that nurses not only use developed tools, but they also help develop new HIE applications to improve care quality. Nurse informaticians may be vital to this effort, since they serve as technical liaisons between HIE services and clinical settings.

As HIE continues to grow, more nurses must be exposed to and develop and understanding of this method of sharing secure patient data. Doing so will help improve patient care and outcomes, reduce costs, and better coordinate care between all members of the healthcare team.

Sarah Handzel, BSN, RN
Freelance Health and Medical Content Writer, Wolters Kluwer Health
Sarah has over nine years’ experience in various clinical areas, including surgery, endocrinology, family practice, and pharmaceuticals. She began writing professionally in 2016 as a way to use her medical knowledge beyond the bedside to help educate and inform healthcare consumers and providers.
  1. Nahm, Eun-Shim PhD, RN, FAAN, et al. “Health Information Exchange: Practical Overview and Implications for Nursing Practice.” NursingCenter, 2020, nursingcenter.com/journalarticle?Article_ID=5687038.
  2. “Health Information Exchange.” HealthIT.gov, 16 Oct. 2019, healthit.gov/topic/health-it-and-health-information-exchange-basics/health-information-exchange.
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