One Health Record® is Alabama’s health information technology and is available today to work in tandem with your existing electronic health records system, or simply to provide a secure system for sending patient information to other authorized participants. Our mission is to electronically exchange health information between Alabama’s healthcare providers and as a result, improve the quality and efficiency of the healthcare received by Alabama’s citizens. The exchange of health information through the One Health Record® system supports patient‐centered health care and continuous improvements in access, quality, outcomes and efficiency of care.
One Health Record® is guided by the State Health Information Exchange (HIE) Commission which is appointed by the Governor. It is actively partnering with state and federal government, state associations, health insurance payers, and vendors to build the state Health Information Exchange.
Sharing health information among doctors who are treating a patient allows them to be more informed about any medical conditions a patient may have, medications being taken and medical procedures a patient may have had or may need. This prevents duplication of services, medication errors and encourages better communication and coordination about a patient’s care.
One Health Record®enables participants to query the system from within their electronic health record (EHR) systems to access patient health data from other participants. If providers do not have an EHR, a secure messaging system is available. Any licensed provider with Internet access can participate in One Health Record®. Providers that participate in One Health Record® will benefit from:
• The ability to streamline office workflow by moving away from paper-based systems, reducing potential for errors and duplication
• The ability to receive critical patient information as needed whether in the office or in the emergency room
• Access to information to improve patient care and safety, avoid duplication of services and ultimately reduce health care costs
• Support to meet Meaningful use requirements for connectivity
• The opportunity to make more informed treatment decisions, provide a clear history of previous treatment, improve overall treatment and outcomes
• Improved care coordination among health care providers by providing a longitudinal health care record (timeline view)
• It will alert you to the admission, discharge, or transfer of your patient at a hospital
The goal of One Health Record® is to seamlessly and securely connect doctors, hospitals, clinics and other healthcare providers so patient information is available in real time, regardless of location.
Using secure Internet technology, participants exchange or move health related information between organizations such as hospitals and doctors according to nationally-recognized standards. HIEs are also known as health information networks or HINs. Any licensed provider with Internet access can participate in One Health Record®. To fully benefitfrom a health information exchange, most doctors, hospitals and other providers link to an HIE via an electronic medical record system.
According to the HIMSS.org FAQ page, the term “HIE” is generally used as either a verb or a noun:
HIE (verb) – The sharing action between any two or more organizations with an executed business/legal arrangement that have deployed commonly agreed-upon technology with applied standards for the purpose of electronically exchanging health-related data between the organizations.
HIE (noun) – A catch-all phrase for all health information exchange, including Regional Health Information Organizations (RHIOs), Quality Information Organizations (QIOs), Agency for Healthcare Research and Quality (AHRQ)-funded communities and private exchanges.
An Electronic Health Record (EHR) is a longitudinal health record of patient health information generated by one or more encounters in any care delivery setting. The EHR automates and streamlines the clinical workflow.
EHRs include information on patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports and images.
Health-related information contained in an EHR conforms to nationally recognized interoperability standards, and can be created, maintained and consulted by authorized clinicians and staff across more than one healthcare organization.
The EHR has the ability to generate a complete record of a clinical patient encounter, as well as supporting other care-related activities directly or indirectly via interface, such as through evidence-based decision support, quality management and outcomes reporting.
One Health Record®enables participants to query the system from within their electronic health record (EHR) systems to access patient health data from other participants. If providers do not have an EHR, a secure messaging system is available.
Care coordination – This is a dynamic process that requires data movement across platforms and among service providers in real time. Many EHR systems, in spite of being developed by the same company, do not talk to each other, creating delays and decreasing the value of the system.
Record Locator Services / Master Patient Indexes – Enable creation of one continuous community record, facilitating patient identification across multiple provider settings.
Data exchange – HIEs/HIOs provide support for vocabulary and code sets including content mapping, and enable data transactions to occur automatically across multiple providers and settings.
Data aggregation and analysis – This includes clinical data aggregation across HIE partners, as well as data analytics and warehousing.
Performance outcome management – Population-level data analysis is an essential component of pay-for-performance programs, ACOs, public health systems and other stakeholders.
Business intelligence analytics – Enable better risk analysis and better, more cost-effective care of high-risk patients.
Clinical messaging – Standard HIE services often include laboratory results, emergency room notes, medication lists, discharge summaries, progress notes, radiology results and surgical notes.
Support for EHR, PHR and MU adoption consultation – HIEs and HIOs facilitate the preparation of scorecards for services using claims and EHR data, and support achievement of Meaningful Use (MU) requirements. (For additional information, see HIE Organizations Supporting Meaningful Use Stage 2 Goals in the HIMSS HIE Toolkit.)
Patient consent – Where consent is not governed by other laws or regulations, an HIE-based centralized consent management process can enable consensus among the community’s stakeholders for a patient consent model.
Connectivity – HIEs/HIOs provide connectivity choices such as DIRECT, the eHealth Exchange and other connectivity services.
New care delivery methods – HIEs/HIOs can be essential components in both the development and operation of ACOs and Patient-Centered Medical Homes (PCMH).
Data sharing – Consolidation and reduction of data interface costs by data sharing for patient demographics, Electronic Medical Record (EMR) data feeds, laboratory data, radiology data and scanned paper documents.
What if patients do not want their information shared?
Participation in One Health Record® is voluntary. Patients may choose to “opt-out” by notifying their health care provider and completing a short form. Once the form is signed, the provider will update the patients’ record within the One Health Record® system. Opt Out assistance is also available through our Service Desk at 844-746-3540.
How are privacy and security of patient health information ensured?
State-of-the-art systems are employed by One Health Record® to secure records to the greatest degree possible and prevent access to unauthorized persons. Any system used must comply with the security provision of the federal Health Insurance Portability and Accountability Act (HIPAA). (see One Health Record®‘sPolicies and Procedures manual for further details.)
Here is one example of how One Health Record® works: A man is in an auto accident and is not only injured but unconscious. He is transported to the closest emergency department where the staff is able to locate his health information on One Health Record®. This is life-saving for him as the physicians and nurses find that he has severe allergies to certain medications that, without this information, would have been given to him.
The HIMSS.org FAQ pageoffers these examples of HIE workflows (One Health Record® supports all of the following):
Secure messaging between providers – HIEs/HIOs can be used for generalized communication between physicians in different healthcare entities and/or using different EHRs. For instance, providers needing to send transition of care documents for consultations or referrals can use HIE services to eliminate sending paper documents, and to expedite the patient’s treatment.
Patient intake – Using an HIE’s/HIO’s query and response process, the patient’s summary clinical record can be pre-fetched and available immediately when the provider wants to look at it.
Patient exam – A physician can utilize an HIE or HIO to access the appropriate patient data from other sources, such as other providers and hospitals. The physician can then select certain patient documents (such as medication lists and reconciliations, allergy lists or lab reports) that they want to have filed in their local EHR for access during a patient visit.
Query services – Physicians may want to obtain more information about a patient that is referred to their office. They can query their local HIE/HIO and, using the IHE Cross-Community Patient Discovery (XCPD) locator services profile, the local HIE/HIO can query other HIE service providers to assemble a full Patient Health Record (PHR).
Interoperability among EHRs – Different healthcare entities may use different EHR systems which cannot connect to one another. HIEs and HIOs can play a key role in enabling communication between disparate systems.