Public Health Informatics and Health Information Exchange

  • J. A. MagnusonEmail author
  • Paul C. FuJr.
Part of the Health Informatics book series (HI)


Health information exchange (HIE) describes both (1) the act of sharing of clinical and administrative health care data between interested stakeholders and (2) the actual health information technologies and systems that facilitate this sharing. There have been multiple iterations of this concept over the past three decades, starting with the Community Health Information Networks of the 1980s, the Regional Health Information Organizations of the late 1990s - early 2000s, and now the health information exchanges that exist in various forms and offer services ranging from basic connectivity to more advanced functions such as master patient indexes, provider directories, trust services, e-prescribing, and public health reporting. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 has helped to promote HIE by including HIE reporting as a Meaningful Use Stage 2 measure and funding the State HIE Cooperative Agreement Program which provides funding for a state designated entity (SDE) to plan and build HIE capacity. There are many challenges to address. Data and messaging standards are required for semantic interoperability. The complexity of information privacy and security policies and regulations increases proportionately with the number of HIE participants. Governance and sustainability are also major challenges that must be met. The future of HIE is promising. The increasing adoption of EHR systems creates a pool of electronic health data that can support public health needs, such as automated reporting for communicable diseases, predictive analysis for syndromic surveillance, and population health reporting.


Synchronous Asynchronous Vertical Horizontal Diagonal Health information exchange Community health information network Regional health information organization Nationwide Health Information Network Interoperability Governance Privacy Security Meaningful use Information models 


  1. 1.
    Adler-Milstein J, Jha AK. Sharing clinical data electronically: a critical challenge for fixing the health care system. JAMA. 2012;307(16):1695–6.PubMedCrossRefGoogle Scholar
  2. 2.
    The Future of Public Health. Committee for the Study of the Future of Public Health; Division of Health Care Services. Washington, D.C.: National Academies Press; 1988. Available from: Cited 6 Apr 2013.
  3. 3.
    Global Pulse Journal. A Conversation with Dr. Julio Frenk, June 2009. Available from: Cited 6 Apr 2013.
  4. 4.
    Duncan KA. Evolving community health information networks. Front Health Serv Manage. 1995;2(1):5–41.Google Scholar
  5. 5.
    Duncan KA. CHINs in the context of an evolving health care system. Proc AMIA Annu Fall Symp. 1996;604–7.Google Scholar
  6. 6.
    Payton FC, Brennan PF. How a community health information network is really used. Commun ACM. 1999;42(12):85–9.CrossRefGoogle Scholar
  7. 7.
    Walker J., et al. The value of health care information exchange and interoperability. Health Aff (Millwood). 2005. Suppl Web Exclusives: W5-10-18.Google Scholar
  8. 8.
    Shapiro JS, et al. Approaches to patient health information exchange and their impact on emergency medicine. Ann Emerg Med. 2006;48(4):426–32.PubMedCrossRefGoogle Scholar
  9. 9.
    Frisse ME, Holmes RL. Estimated financial savings associated with health information exchange and ambulatory care referral. J Biomed Inform. 2007;40(6 Suppl):S27–32.PubMedCrossRefGoogle Scholar
  10. 10.
    Halamka J, et al. Exchanging health information: local distribution, national coordination. Health Aff. 2005;24(5):1170–9.CrossRefGoogle Scholar
  11. 11.
    U.S. Department of Health and Human Services. Information for health: a strategy for building the national health information infrastructure. Washington, DC: National Committee on Vital and Health Statistics; 2001.Google Scholar
  12. 12.
    Yasnoff WA, et al. A consensus action agenda for achieving the national health information infrastructure. J Am Med Inform Assoc. 2004;11(4):332–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academies Press; 2001.Google Scholar
  14. 14.
    Kaushal R, et al. The costs of a national health information network. Ann Intern Med. 2005;143(3):165–73.PubMedCrossRefGoogle Scholar
  15. 15.
    Walker J., et al. The value of healthcare information exchange and interoperability. Health Aff. 2005;Suppl Web Exclusives:W5-10-18.Google Scholar
  16. 16.
    Adler-Milstein J, et al. The state of regional health information organizations: current activities and financing. Health Aff (Millwood). 2008;27(1):w60–9.CrossRefGoogle Scholar
  17. 17.
    Frohlich J, et al. Retrospective: lessons learned from the Santa Barbara project and their implications for health information exchange. Health Aff (Millwood). 2007;26(5):w589–91.CrossRefGoogle Scholar
  18. 18.
    Miller RH, Miller BS. The Santa Barbara county care data exchange: what happened? Health Aff (Millwood). 2007;26(5):w568–80.CrossRefGoogle Scholar
  19. 19.
    ONC. Nationwide Health Information Network. Available from: Cited 7 Apr 2013.
  20. 20.
    West DM, Friedman A. Health Information Exchanges and Megachange. Governance Studies at Brookings. Feb. 8, 2012.Google Scholar
  21. 21.
    Blumenthal D. Launching HITECH. N Engl J Med. 2010;362:382–5.Google Scholar
  22. 22.
    Integrated Healthcare Association. Accountable care organization provisions in the patient protection and affordable care act. Available from: Cited 7 Apr 2013.
  23. 23.
    American Hospital Association. The American recovery and reinvestment act: calculating medicare it incentive payments. Available from: Cited 7 Apr 2013.
  24. 24.
    Centers for Medicare and Medicaid Services. February 2013 medicare and medicaid incentive programs payment and registration report. Available from: Cited 7 Apr 2013.
  25. 25.; Policymaking, Regulation, & Strategy. Meaningful use. Available from: Cited Apr 6 2013.
  26. 26. How to attain meaningful use. Available from: Cited 7 Apr 2013.
  27. 27.
    ONC.State health information exchange resources. Available from: Cited Apr 7 2013.
  28. 28.
    S&I Framework. Provider directories reference materials. Available from: Cited 7 Apr 2013.
  29. 29.
    Office of the National Coordinator for Health Information Technology. Health information exchange strategic and operational plan profile. Available from: Cited 7 Apr 2013.
  30. 30. What is HIE?. Available from: Cited 7 Apr 2013.
  31. 31.
    US Department of Health and Human Services. State health information exchange program. Available from: Cited 7 Apr 2013.
  32. 32.
    HIMSS. A HIMSS guide to participating in a health information exchange. Available from: Cited 7 Apr 2013.
  33. 33.
    Federal Register. Health Information Technology: Revisions to the 2014 Edition Electronic Health Record Certification Criteria; and Medicare and Medicaid Programs; Revisions to the Electronic Health Record Incentive Program. Available from: Cited 7 Apr 2013.
  34. 34. Frequently asked questions. Available from: Cited 7 Apr 2013.
  35. 35.
    US Department of Health and Human Services. Health information privacy. Available from: Cited 7 Apr 2013.
  36. 36.
    National eHealth Collaborative Discussion Panel. Challenges and barriers to successful HIE implementation. March 27, 2009.Google Scholar
  37. 37.
    Public Health Data Standards Consortium. Assure health IT standards for public health: clinical document architecture (CDA) for public health. Available from: Cited 7 Apr 2013.
  38. 38.
    University of Kentucky News. UK initiates first cancer reporting model of its kind in U.S. Available from: Cited 7 Apr 2013.
  39. 39.
    FierceHealthIT. State health workers granted online access to patient info during meningitis outbreak. Available from: Cited 7 Apr 2013.
  40. 40.
    Massachusetts eHealth Institute. MeHI introduces new public health surveillance tool: MDPHnet. Available from: Cited 7 Apr 2013.
  41. 41.
    HealthVault. Available from: Cited 7 Apr 2013.

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Department of Medical Informatics & Clinical EpidemiologyOregon Health & Science University, Biomedical Information Communication Center (BICC)PortlandUSA
  2. 2.David Geffen School of Medicine at UCLALos AngelesUSA

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