Have you ever opened a chart of a very sick or obtunded patient, only to find it completely blank? Of course you have…probably at some point today. The minor panic that having to find vital collateral information in a timely fashion induces can be hard to shake. Is it unavoidable?

Traditionally when health records were shared, they were communicated via telephone, fax, or email. The traditional methods of transmitting medical records are still heavily relied upon, but studies have shown that the traditional methods take significant time and are prone to missing and/or incorrect information (1). This can then lead to misdiagnosis, duplication, and ultimately suboptimal treatment.

Unlike most aspects of Informatics, the need for Health Information Exchange (HIE) is readily apparent. If executed properly, it could potentially alleviate the above mentioned problems. The basic theory of HIE is that it allows access to all of the useful aspects of a patient medical history (including notes, labs, imaging, studies) by a current provider, without regard to when or where the data was generated.

All HIEs are slightly different, however, and tend to differ around the following points: the richness of information transmitted (Notes vs. Full chart), who is allowed access (small clinics may not have the ability to connect), how the information is sent (push vs. pull), and setting what the rules of exchange (governance entities) (1).

Despite generous funding at the federal and state level , however, HIE remains more aspiration than realized solution. The reasons for this are many, and too long for this post, but suffice it to say that HIE remains a very active field of study within the informatics umbrella. Given the enormous promise it holds for unifying a very fragmented health-scape, it is likely to stay an active field of study for years to come.



Holmgren, A. J. and J. Adler-Milstein (2017). “Health Information Exchange in US Hospitals: The Current Landscape and a Path to Improved Information Sharing.” J Hosp Med12(3): 193-198.

June 2024