Different Types of Health Information Exchange

Information exchange can take many forms. The simplest form of exchange is query-based where a physician can search for a patient's information through an information network. Family physician Jennifer Brull says she takes a few minutes the night before patient visits to query the next day's patients through her exchange, the Kansas Health Information Network (KHIN). If she finds any relevant information, like an X-ray or test result, she downloads it into her patient's EHR.

A push model or directed exchange is where patient information is sent electronically to specific providers; for instance, if a specialist wants to report results to the referring physician.

Consumer-mediated exchange allows patients to collect all their health data in one place, through a patient portal or personal health record, and to share that data with their physicians.

"Direct" is a technical standard developed by the government and private industry that allows healthcare entities to securely exchange protected health information. Sending messages using the Direct platform is much like sending an e-mail, but with added layers of security. "Direct is a federally required protocol that is embedded in any 2014-certified EHR system," says Laura McCrary, executive director of KHIN. "It follows the federal requirements for the sharing of personal health information. It really is just the replacement for the fax machine." Physicians wishing to exchange information through this platform must request a Direct address from their EHR vendor, state health information exchange, or private service provider - one that looks much like any e-mail address.