The purpose of this discussion is to apply my knowledge and think like an Advanced Practice Nurse about HIEs (health information exchanges).
The historical and current state of HIEs and HIE initiatives in the nation is fundamental to several acts and provisions to promote the interoperability of healthcare systems. eHealth Exchange (eHEX) aims to bring federal and non-federal organizations together to support health information exchange. The goal of the Trusted Exchange Framework and Common Agreement (TEFCA) system is to establish a nationwide HIE with standards that govern the sharing of electronic health information (EHI).
Different data exchange models have different advantages and challenges associated with them.
Effective and accurate data exchange across the nation is likely the largest challenge to achieve nationwide interoperability. To counter this challenge, several standardization organizations are constantly working to establish universally accepted standards that organizations can use to facilitate safe, accurate, and efficient data exchange.
Patient portals can improve individuals’ access to their health information to better engage in the care delivery process. Studies have shown that patient portal, patient activation, and subsequently, patient safety and quality of care delivery are all intertwined as changes as one impacts the others. Research has shown that there are certain vulnerable populations, as well as those with low health literacy, that are at high risk of unintended healthcare events and unsuccessful care delivery.
SCENARIO:
A 42-year-old male scientist, along with his wife and two children, from a tiny town called Albarracin, (about 4 hours outside Madrid, Spain), traveled to San Diego with a dual purpose…for him to interview for a job at the famous the Salk Institute Laboratories and to scope out the area as a potential place to relocate. Their primary spoken language is Spanish (Castilian Spanish), with the hope to one day master English. Since they traveled so far, a first-time visit to the U.S. no less, they decided to tack on some leisure time as a family. Next stop, Vale, Colorado for a few days of skiing. before heading back to Spain.
Anyone who has ever skied understands that you should never say aloud- ‘This is the last run of the day’. It is believed to be a jinx of sorts. Well, Elena, the wife of the scientist, was feeling fatigued as it was quite late in the day, and as she nearly reached the bottom of the mountain, her ski hit the edge of a rock near the treeline. She fell and broke her ankle. All she kept thinking was, ‘I never should have said I’d take one last run’. Despite the fact that she is an expert skier, she is also a Type I Diabetic. Rushed by ambulance to the local hospital, the doctors tried to access her medical records from Spain. HIE standardization throughout the United States has a long way to go before a seamless process is realized, but international e-data adds a completely new dimension of complexity. The emergency department doctor called her doctor, directly, asking to email the records (Madrid to Colorado). Elena was airlifted to the regional hospital, stabilized with her glucose levels, and then sent to surgery, where 5 screws were inserted into her ankle. The surgeon emailed the before and after pictures to Elena’s primary physician near Madrid. The family spent another week nearby the U.S. hospital so they could visit. A patient portal was set up for Elena, and she was discharged home for recuperation near her hometown.
COVER ALL OF THESE IN YOUR DISCUSSION:
List the main challenges that Elena and her family have faced. Keeping in mind that the patient and family go hand-in-hand.
Briefly discuss the current overall state of HIE’s in the United States.
Do you believe it was ethical for the doctors to email each other (including patient photos) via a non-secured health network? Why or why not? Are there extenuating circumstances?
The patient portal is in English only. Identify the primary problem and offer a short and long-term solution.
Review the following resource to prepare for the discussion:
Website: https://www.healthit.gov/isa/ Interoperability Standards Advisory (ISA)
Review the latest information regarding standards and their relationship to EHR certification.
