Frequently Asked Questions
- What is the Arkansas Office of Health Information Technology?
- What is health information technology?
- What is health information exchange?
- What is SHARE?
- How does SHARE work?
- What is an electronic health record (EHR)?
- How are EHRs used?
- What are the benefits of HIT?
- How secure are electronic health records?
- Why do we need health information exchange?
- How is health information technology and health information exchange being funded?
- What SHARE security and privacy principles are followed and enforced?
- Can the HIE Record be subpoenaed?
- What is the process, supporting policy and procedure for highly sensitive Protected Health Information?
- Is a hospital liable if it has access to the data in the HIE and does NOT use it for treatment?
- Can non-SHARE users access my protected health information for data mining purposes?
- Are Participants required to get the patient’s signature on the opt-out form?
The Office of Health Information Technology was established to provide leadership for the development and implementation of a statewide health information exchange in Arkansas. The roles of the office are to coordinate health information technology planning, development, implementation and financing, and plan the development and operation of the SHARE, the health information exchange.
Health Information Technology (HIT) is the electronic storage, retrieval, sharing and use of health care data for communication and decision-making.
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.
The State Health Alliance for Records Exchange (SHARE) is Arkansas’s health information exchange. SHARE allows doctors and hospitals to share and retrieve health information in a secure, electronic manner.
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. Also known as an electronic medical record or EMR.
- 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: The ability for all doctors and other providers participating in the care of a patient in multiple settings to quickly access new and past test results will increase patient safety and effectiveness of care.
- Orders management: The ability to enter and store orders for prescriptions, tests, and other services in a computer-based system will enhance legibility, reduce duplication and improve the speed with which orders are executed
- Clinical decision support (CDS): Using reminders, prompts, and alerts, CDS will improve compliance with best clinical practices, ensure regular screenings and other preventive practices, identify possible drug interactions, facilitate diagnoses and treatments and reduce the frequency of adverse events
- Electronic Communication and Connectivity: Improved communication among doctors, providers and other partners, such as laboratory, pharmacy, and radiology professionals, can enhance 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 will encourage greater involvement of patients in their own health care.
- Improved quality and safety: HIT allows doctors and other providers to access important medical information about their patients and have a more complete understanding about a patient’s condition and treatments. This can improve care coordination and results.
- Reduced costs: Studies have shown that HIT tools can help reduce costs by reducing duplicative tests or repetitive clinical tests. Eliminating paper from the health care system also results in administrative cost savings and improved efficiencies.
- Access to patient information in an emergency or natural disaster: HIT tools can give providers the critical information they need in an emergency in a timely manner or if a patient arrives at the emergency room unconscious. In disaster situations, records might not be accessible at the location they were first recorded. HIT would allow providers to retrieve that information. Disasters such as floods, hurricanes, or fires can destroy paper records. Electronic health records can be backed up securely and stored in several locations.
Traditional methods for securing medical records are regulated to lock-and-key solutions for protecting physical medical record files. Electronic health records provide a high level of accountability for use and access through enhanced security and privacy layers such as electronic access control, electronic logging of access and use, electronic auditing of access, and the ability to review individual access to data in near-real time. These enhanced security operations are in addition to and build on traditional security controls such as housing resources within physical secure locations.
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 readily 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 patients’ medical history, such as lab tests, medication history, problem list, allergies, and other health reports. By having access to more complete medical history, providers and patients can make more informed decisions about the patient’s care plan, thus improving the quality of that care and avoiding medial errors.
Arkansas received $7.9 million in funding as part of the State Health Information Cooperative Agreement Program made available through the Office of the National Coordinator for Health Information Technology (ONC). This money will cover the initial costs of planning and developing the health information exchange.
There are several other HIT-related federal stimulus grants that have been awarded to several different agencies and organizations in Arkansas for:
- Regional extension centers that help doctors make the transition from paper to electronic health records
- Incentive payments, (based on population and Medicaid enrollment), for doctors, hospitals, and other health care providers who become meaningful users of electronic health records
- Increased matching funds to cover states’ administrative costs for Medicaid
- Broadband and telehealth
- Electronic health record adoption in community health centers
Existing privacy and security requirements under the Health Information Portability and Accountability (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) Acts that cover access to and use of health information apply to electronic health information as well as traditional paper documentation. SHARE uses technologies, policies and processes to incorporate HIPAA and HITECH requirements into the management and oversight of health information that is exchanged through SHARE.
Yes, the HIE Record may be subpoenaed. OHIT will comply with all applicable state and federal laws in making disclosures of Protected Health Information.
What is the process, supporting policy and procedure for highly sensitive Protected Health Information?
A Participant will not be liable for access, which complies with all applicable policies and regulation. The OHIT Privacy Policies 400 and 1200 state that all Participants are responsible to access, use and disclose Protected Health Information though SHARE consistent with applicable federal and state laws and regulations. Participants are all responsible for training and supervising their authorized users consistent with the Participants’ and OHIT’s privacy policies and the terms of the Participation Agreement.
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 data mine under HIPAA nor are they permitted to sell data without a patient’s authorization. Additionally, data disclosed for payment purposes is restricted by HIPAA to the minimum amount necessary to accomplish the purpose of the disclosure.
OHIT Policies allow the Participant to determine the process by which to notify OHIT when a patient has opted out. OHIT will use the documentation supplied by the Participant for auditing purposes.