Frequently Asked Questions for Patients
- What is health information exchange?
- Why do we need health information exchange?
- What is SHARE?
- How does SHARE work?
- What is an electronic health record (EHR)?
- How are EHRs used?
- What parts of my health information is included in SHARE?
- Can I access my SHARE record?
- Will all of my health information from the past be included in SHARE?
- Can I opt-out of SHARE with certain providers, or exclude parts of my medical record?
- Do I need to opt-out of SHARE with each of my providers?
- Can non-SHARE users access my protected health information for data mining purposes – either for marketing health products or services to me or other purposes?
Health Information Exchange (HIE) provides the capability to electronically move clinical information between disparate health care information systems to facilitate access to and retrieval of clinical data, thereby helping to provide safer, timely, efficient, effective, equitable patient-centered care.
Patients usually visit many different providers and go to different locations to receive health care, including doctors, nurses, hospitals, nursing homes, community health centers, and pharmacies. Each provider and location keeps its own medical records on its patients but providers cannot electronically access records and important information about their patients’ care from other locations. Doctors and other health care providers can give patients better care and avoid mistakes if they have access to their complete medical history, such as lab tests, medication history, problem list, allergies, and other health reports.
The State Health Alliance for Records Exchange (SHARE) is Arkansas’s health information exchange. SHARE allows unaffiliated doctors and hospitals to share and retrieve health information with each other in a secure, electronic environment.
When all parts of the Arkansas health care system use standardized electronic health records and connect those systems to SHARE, it will be possible for patients to ensure that their doctors, hospitals, clinics, insurers and pharmacies have the information they need at the time and place they need it to provide the best treatment possible.
In many offices, patient information is collected and stored the same way as it was decades ago: in bulky paper files kept in one practitioner’s office. The doctor sees a patient, jots down notes in a folder, fills out a form to order tests, and scribbles out a prescription on another piece of paper. Later, if the patient needs to see a specialist or get a prescription filled, numerous paper records must be retrieved, copied and sent. Health care providers in Arkansas are transitioning to electronic health records (EHR), with 37 percent of providers using EHRs in 2011, and marked increases in adoption every year.
But moving from a paper-based system to an electronic system for managing health information does not help the majority of patients who see more than one doctor. How can all of their treating providers have a complete picture of the patient’s health when each provider only keeps their piece of the patient’s medical information? SHARE is the answer to this problem.
Electronic health records connected through SHARE allow a patient seeing a doctor in one part of the state to share or retrieve health information from a health care provider (e.g. hospital, lab, or surgeon) in another part of the state – instantly and accurately, to ensure timely and informed delivery of care.
An electronic record of patient health information, including patient demographics, notes, problems, medications, vital signs, medical history, immunizations, laboratory data, and radiology reports that has the ability to generate a complete record of a clinical patient encounter. These are also known as an electronic medical record or EMR.
Health care providers use EHRs for the following purposes:
- Health information and data: Immediate access to key information, such as patients’ diagnoses, allergies, lab test results, and medications, improves the ability for doctors and other health care providers to make clinical decisions in a timely manner.
- Results management: Doctors and other providers participating in the care of a patient in multiple settings can quickly access new and past test results, which increase patient safety and effectiveness of care.
- Orders management: Enter and store orders for prescriptions, tests, and other services in a computer-based system to enhance legibility, reduce duplication and improve the speed with which orders are executed.
- Clinical decision support (CDS): Using reminders, prompts, and alerts, CDS improves compliance with best clinical practices, ensures regular screenings and other preventive practices, identifies possible drug interactions, facilitates diagnoses and treatments and reduces the frequency of adverse events.
- Electronic Communication and Connectivity: Improved communication among doctors, providers and other partners, such as laboratory, pharmacy, and radiology professionals, enhances patient safety and quality of care. Electronic communication tools, such as e-mail and web messaging, have been shown to be effective in facilitating communication both among providers and with patients, thus allowing for greater continuity of care.
- Patient support: Tools that give patients access to their personal health records and provide interactive patient education encourage greater involvement of patients in their own health care.
- When does my health information get into SHARE?
- When your doctors or hospitals participate in SHARE, they are required to tell you and give you an opportunity to opt-out at your next visit. If you do not opt-out, they will push your health information into SHARE.
Only parts of your health information will be available in SHARE. Lab results, x-ray results, medical diagnosis information, medication allergies, doctor’s notes, drugs you are currently taking and immunization history can be available in SHARE. Each participating provider will decide what patient information, from this list, they will put into SHARE, and how far back that information will be dated.
You will not be able to login to SHARE to access your health information—only authorized health care entities can access SHARE. However, you may be able to view your aggregated records from other providers if you see a doctor that participates in SHARE and uses an electronic medical record system that is capable of pulling your record from SHARE for you to view.
Not all of your health information from the past or present will be in SHARE. First, in order for your health information to be in SHARE, your health care providers must participate in SHARE, and you must give your providers consent to disclose your information through SHARE. Second, each participating health care provider decides what patient health information to put into SHARE, and how far back that data will reach. Some participating hospitals are pushing up to two years of patient data into SHARE (data from 2011 onward). Ask your participating provider what information they are sharing about you, and how far back the information dates.
No, you cannot opt-out of SHARE with certain providers. SHARE cannot exclude specific visits, tests or episodes of care, or specific providers. If you decide to participate, your health information from all of your participating health care providers will be available in SHARE. If you do not want to participate, you can opt-out. This means no one will be able to access your health information through SHARE except in an emergency. If you have paid out-of-pocket for an episode of care that you do not want in your medical record, you will need to tell your doctor that you want it excluded from SHARE.
No. Opt-outs are all-encompassing, so you only need to opt-out with one provider to opt-out with all providers. SHARE will flag your record as “Opted-Out,” which will prevent any providers from viewing your information through SHARE except in an emergency.
Can non-SHARE users access my protected health information for data mining purposes – either for marketing health products or services to me or other purposes?
No, only participating health care providers that are involved in your treatment or in the payment for your medical care can see your records. OHIT Policy 100 requires that all Participating Entities be either a) Covered entities under HIPAA or b) in a Participant Relationship w/ OHIT. Covered Entities are not permitted to mine data under HIPAA, nor are they permitted to sell data without a patient’s authorization.