Query HIE Toolkit
This toolkit provides an overview of Query HIE to assist providers in adopting this advanced Health Information Exchange (HIE) method. Query HIE leverages the Query-based Exchange method to improve health care. The content is subject to change, as it is being developed with input from MeHI's Fall 2019 Query HIE Learning Collaborative.
Query HIE Networks
To participate in Query HIE, providers first need to become a member of a Query HIE Network that connects providers who are willing to exchange information via Query HIE.
A Query HIE Network offers the participating providers the functionality needed for Query-based Exchange of patient health information.
In recognition of the potential of Query HIE to improve healthcare, there are many private and public initiatives that work on making Query HIE functionality widely available.
The effectiveness of a Query HIE Network depends on how many providers participate in the network. The more providers that make information available on the network, the better the network works.
Some of the initiatives collaborate with each other to connect their Query HIE Networks together, as combining their networks will enable their participants to exchange health information with many more providers across both networks.
The two most commonly used and widespread public initiatives to create large Query HIE Networks include:
Carequality is an initiative that provides a framework of common standards and rules to Query HIE implementers. For instance, Epic has implemented its Query-based Exchange solution based on this framework, and its users have been able to conduct Query HIE within the Epic universe for several years.
Commonwell Health Alliance is a consortium that provides Query HIE services to users of other EHR products, including Cerner, Meditech, or Athenahealth, for example. Commonwell adopted the Carequality framework and its users can now exchange information with EHRs that have incorporated Carequality.
Both initiatives consisted of a wide network of members. With Commonwell’s adoption of the Carequality framework, they significantly increased the accessibility to patient information. Their members can now enable a connection to Carequality, allowing them to bilaterally exchange data with providers who implemented Carequality.
More detail on how these two initiatives operate follows below the next section.
EHR and Clinical System Vendors
How you can participate in Query HIE depends on your EHR or other clinical system vendor. If the vendor has their own Query HIE Network, implemented Carequality, and/or is connected to Commonwell, you can quickly gain access to a large network.
If a connection to a Query HIE Network is not yet in place, you can consider working with the vendor to establish a connection. To make that work seamlessly, your vendor will have to conduct an integration project so the health information can be queried by and pulled from your system by the network.
Some vendors support Query HIE functionality but only in their more recent version release(s). If this is the case, you will have to conduct an upgrade project to get onto the latest release.
The “Vendor Status Directory” tab provides an overview of the EHR and clinical system vendors that have adopted Query HIE. This includes details on the functionality they provide and whether they are members of Carequality and/or Commonwell.
Carequality is referred to as a network-to-network trust framework. The initiative is not a Query HIE Network and does not supply Query HIE capability. Instead, it provides a framework of standards and rules to implement Query HIE. Its members implement the standards and rules to exchange patient records via connected HIE networks. As such, these members make up Carequality’s Query HIE Network.
The framework can be used by EHR and other clinical system vendors to implement a standardized Query HIE solution, regardless of the HIE network they already belong to, including federal and state based government networks. A number of vendors have integrated the framework into their system.
The goal of the Carequality initiative is to link all the HIE networks in the same way the cellphone carrier networks are linked. Carequality’s framework creates a common legal structure that all members of the networks adhere to.
Carequality also provides and enforces the use of technical specifications and standards: message types, meta-data requirements, and data formatting and codeset rules. Epic, Cerner, and Commonwell Health Alliance are all members.
To learn more about Carequality, click here.
Commonwell Health Alliance is an actual Query HIE Network. Its members include healthcare organizations, Health Information Exchanges, and EHR vendors, who have agreed to share patient records. The network was designed to simplify the exchange of patient records and to make the records available when they are needed.
Commonwell provides Query HIE functionality that EHR vendors can integrate into their EHR systems. This consists of a Record Locator Service, a set of Patient Linking and Identification algorithms, and a document query and retrieval broker/accelerator service. This functionality includes the Query, Select, and Retrieve features required for Query HIE.
Providers must implement a patient enrollment workflow process to add a patient to the Record Locator database. This allows you to search for a patient by various demographic data. Once the patient is matched, you are shown the list of documents available for the patient. You can then review these documents and decide which to incorporate into your patient’s record.
Only patient records from providers who have also signed up for query service will be visible in the search. Furthermore, patients must consent to their records being made accessible for Query HIE.
In addition, Commonwell offers providers the opportunity to opt-in to a service called Carequality Connection. This service allows Commonwell providers to connect and bilaterally exchange patient health data with Carequality-enabled healthcare provider sites.
To learn more about Commonwell Health Alliance, click here.