Welcome to HIETexas, your source of information about electronic health information exchange (HIE) in Texas.
As a Texas physician, hospital administrator, or other healthcare provider you have likely been hearing about electronic health records (EHR) and about federal incentives for the adoption of EHR. You may currently use paper-based health record-keeping systems, have already adopted EHR, or be in the process of EHR adoption. More recently you may have also begun to hear more about electronic health information exchange, or HIE.
You may live in one of the state's major metropolitan areas now being served by a local, community-based HIE. Or you may live and practice in the predominantly rural areas of Texas not served by an HIE, commonly referred to as the Texas White Space.
Regardless of where you live and practice in Texas and your status regarding health records, Texas' approach to HIE provides you with opportunity to participate in health information exchange.
Please explore the answers to questions below and other pages in this site for information about Texas HIE and how it can benefit you.
What is Health IT (HIT)?
Health information technology (HIT) is the use of computer-based technology to securely store, organize, and exchange health information. HIT is changing the way healthcare is provided, and has already been employed in many ways. Now, through HIE, it can help directly impact the way you provide healthcare by enabling conversion to electronic health records (EHR) to reduce paperwork burdens and make records more immediately accessible. It can also enable the secure, and often immediate, electronic exchange of patient information between you, referral physicians, labs and pharmacies, public health agencies, and payers.
What are electronic health records (EHR)?
Electronic health records (EHR) are electronically stored versions of patient medical records. An EHR may contain information such as:
- Medical history
- Medication and immunizations history
- Radiology images and lab test results
Electronic records are immediately retrievable when needed. With the development of the ability to electronically exchange records via HIE, EHR can be accessed quickly and exchanged with other care providers as appropriate.
The federal Office of the National Coordinator for Health Information technology (ONC) has funded four Texas Regional Extension Centers (RECs) to help primary care providers adopt and use electronic health records (EHRs). REC services include outreach and education, EHR support, and technical assistance in implementing health IT and using it in a meaningful way to improve care.
For more information on EHR and EHR adoption, and on the Texas RECs, choose from select the following:
- Texas Regional Extension Centers
- The federal Office of National Coordinator for Health Information Technology (ONC) provides more information about the benefits of EHR.
- The federal Office of National Coordinator for Health Information Technology (ONC) provides more information about preparing for adoption of EHR.
What is "Meaningful Use" of EHR?
The federal American Recovery and Reinvestment Act (ARRA) provides incentives for eligible Medicaid and Medicare health care practitioners and hospitals for the "meaningful use" of certified electronic health records (EHRs).
One component of "meaningful use" is the ability to exchange clinical health data across secure electronic networks under clinically appropriate circumstances. Texas is supporting the development of electronic health information exchange (HIE) infrastructure statewide to ensure that Texas physicians and hospitals have an opportunity to be eligible to receive billions of dollars in available federal meaningful use incentive payments over the next decade.
For more information on meaningful use, choose from select the following provided by the federal Office of National Coordinator for Health Information Technology (ONC):
What is health information exchange (HIE)?
Electronic health information exchange, or HIE, is the secure electronic movement of health information among treating physicians and other healthcare providers and related organizations according to national and state laws and nationally recognized standards.
A physician or other care provider can participate in HIE whether or not he or she has adopted the use of electronic health records (EHR). The purpose of HIE is to improve the quality, safety and efficiency of healthcare using health information technology to enable you and other care providers and payers to have the right information in your hands at the right time.
How can HIE improve the quality, efficiency and safety of health care?
HIE enables the electronic exchange of healthcare information through a secure, electronic health information system that safeguards confidentiality by adhering to federal and state laws, rules and standards, and through appropriate levels of patient consent.
HIE makes it possible for treating physicians and hospitals to have rapid, often immediate, electronic access to necessary patient medical information. Access by authorized providers to past clinical information about patients will enable physicians and other clinical care providers to give their patients faster, more accurate and effective, and more efficient care.
- Less waiting for paper files to be delivered from one treating physician to another when a patient is referred for additional treatment or consultation; it provides the ability to send, at the push of a button, test results and images between treating physicians or other care provider, rather than having to send them via fax, or mail, courier, or the patient;
- Reduced office paper load, with electronically-stored medical records making it faster and easier to access and refer to patient records or a record created by another physician;
- Better coordination of care;
- Reduction of unnecessary duplicative tests, x-rays, and other procedures, or the possibility of adverse reactions enabled by the readily-accessed availability of patient histories; and
- Access to up-to-date clinical research and new clinical guidelines.
Why is Texas implementing HIE statewide?
The purpose of HIE is to use health information technology to support improvement in the quality, efficiency and safety of health care by improving access by health care providers to their patients' health information as necessary to ensure that the patient receives the right care, from the right person, at the right time.
Implementing HIE statewide will also help to ensure that Texas physicians and hospitals are eligible to receive billions in available federal meaningful use incentive payments over the next decade. In the long-term, Texas has an opportunity to leverage technology to improve the quality, safety, and efficiency of the Texas health care sector while protecting individual privacy.
What about the privacy and security of patient information?
The THSA believes the patient and consumer should be the focus of all efforts to use health information technology, including HIE.
Federal and state laws protect the privacy and confidentiality of patients' personal health information. The Texas Health Services Authority (THSA), in coordination with the HHSC, with guidance from the Texas Legislature and with input from stakeholders, including healthcare providers' representatives, is working to develop uniform privacy and security standards and policies that reflect federal and state requirements to protect the privacy and security of patient health information in its exchange between authorized health care providers and other related appropriate entities in Texas.
House Bill 300 (82nd Texas Legislature, 2011) required the THSA to develop Texas HIE privacy and security standards and to submit them to the HHSC for ratification by agency rule. HB 300 also required the THSA to develop a voluntary certification program through which entities involved in Texas HIE could be certified as having complied with state standards. Both projects are currently underway via the THSA's collaborative process.
The University of Houston Health Law and Policy Institute, under contract with the HHSC, has developed a series of "white papers" that together help provide a starting point for development of Texas HIE privacy and security policy. To access the UH Health Law and Policy Institute papers, click here.
The federal Office of National Coordinator for Health Information Technology (ONC) provides more information about:
Who does Texas HIE involve?
Texas healthcare patients and their appropriately designated representatives, physicians, hospitals, other health care providers, and insurers or other health care payers have an opportunity to be involved in and benefit from HIE in Texas.
Texas HIE also involves the information exchange partners who together comprise the infrastructure for health information exchange in Texas. They include Texas Local HIE Grant program community-based HIEs, Texas White Space qualified health information service providers (HISPs), and others providing secure health information messaging or more robust exchange services across our state.
Texas HIE also includes the Texas Health Services Authority (THSA) and the Texas Health and Human Services Commission (HHSC), which coordinate together in the development and governance of Texas HIE, and the Texas Department of State Health Services (DSHS), which administers the state Medicaid program and the Center for Health Statistics (CHS), the state's portal for public health data.
What is Texas' HIE Plan?
Texas' plan to develop electronic health information exchange (HIE) statewide is patient-centric, market-based, and community-driven.
In March 2010, the Texas Health and Human Services Commission (HHSC) received an award from the federal Ofﬁce of National Coordinator for Health Information Technology (ONC) for funding through the State HIE Cooperative Agreement Program. The purpose of this program, created by the American Recovery and Reinvestment Act, is to fund state planning and implementation of HIE networks to support higher quality, safer, and more efﬁcient health care.
Texas' allotment through this program is a four-year, $28.8 million grant. The HHSC is serving as the fiscal agent for this funding and the Texas Health Services Authority, under contract with HHSC, is serving as a convening entity to ensure broad input from stakeholders, such as consumers, hospitals, payers, and physicians, on the development and implementation of HIE in Texas.
The Goal - Enable improvements in the quality and efficiency of the Texas health care sector by establishing an electronic HIE infrastructure for the state.
The Objective - Deliver private, secure, and reliable HIE services to all Texas patients and providers through local HIE networks where the capacity exists and through contracts administered from the state level where it does not.
Three Core Strategies -
- General state-level operations administered jointly by THSA and HHSC to support a transparent and collaborative governance structure to coordinate the implementation of HIE in Texas, develop policies and guidelines, and provide statewide HIE services;
- Local HIE Grant Program administered by HHSC with support by THSA to partially fund planning, development, and operations of local and regional HIE networks; and
- "White space" initiative administered by THSA to provide HIE connectivity through health information service providers (HISPs) in regions of the state without local or regional HIEs.
For more information:
General Approach to HIE Implementation
(December 2010, Texas Health Services Authority) PDF
What options do I have for participating in HIE in Texas?
The THSA has created a document, Texas HIE Options, to provide guidance to Texas health care providers regarding options available for meeting federal HIE meaningful use requirements.
Texas HIE Options provides an overview and links to additional information about the Texas Local HIE Grant Program, the rural Texas White Space strategy, and additional service providers who intend to provide secure messaging services to Texas health care providers.
Texas HIE Options Guidance
(December 30, 2011, Texas Health Services Authority) PDF
What is the Texas Local HIE Grant Program?
The HHSC and THSA created a Local HIE Grant Program to provide partial funding for the planning, implementation and operation of local HIE initiatives and networks. Funding to awardees under the program was based on the number of hospitals and physicians each HIE intended to connect.
At a minimum, the Texas Local HIE Grant Program HIEs will support the following HIE services in 2012:
- electronic prescription;
- lab results delivery; and
- clinical summary exchange.
For more information on the Texas Local HIE Grant Program:
What is the Texas White Space Program?
Texas counties, primarily in rural areas of the state, not currently served by a local community-based HIE are often referred to as the Texas "White Space."
The THSA has established a marketplace of qualified Health Information Service Providers (HISPs) to provide basic ("lite") HIE connectivity services to hospitals and physicians located in the Texas White Space, and has initiated a voucher program to help offset some of the initial costs of obtaining connectivity services from a qualified HISP.
For more information about the White Space strategy, the qualified HISPs, and the voucher program:
How can I get involved in HIE in Texas?
You can get involved in HIE in many ways. Here are just a few:
- Contact your county or state medical association or the Regional Extension Center (REC) serving your area to learn more about EHR adoption and certification.
- If you live and practice in one of Texas' major metropolitan areas or surrounding regions served by a Local HIE Grant Program participant HIE, contact that HIE to learn more about its services and opportunities for participation.
- If you live and practice in the predominantly rural Texas "White Space" not served by a local HIE, learn more about opportunities for basic HIE connectivity through the Texas White Space Program.
- If you are interested in learning more about Texas HIE and its development on a policy level, you may want to consider listening in on HIE governance calls, watching THSA board meetings, or even joining a THSA task force.