Health information exchange (HIE) refers to the electronic sharing of clinical data between healthcare organizations, enabling providers to access and use patient information regardless of where care was delivered. HIE encompasses the technology infrastructure, governance frameworks, and data standards that facilitate interoperability across disparate electronic health record (EHR) systems, laboratories, pharmacies, and public health agencies.
There are three primary models of health information exchange. Directed exchange allows providers to send patient information securely to known recipients, similar to encrypted email. Query-based exchange enables providers to search for and retrieve patient data from other organizations during unplanned care encounters. Consumer-mediated exchange gives patients the ability to aggregate and share their own health records across providers. Regional and state-level HIE organizations often serve as intermediaries that connect participating providers through a common technology platform.
The federal government has invested significantly in HIE through the HITECH Act, the 21st Century Cures Act, and the Trusted Exchange Framework and Common Agreement (TEFCA). Effective health information exchange reduces duplicate testing, prevents adverse drug interactions, improves care transitions, and supports population health analytics. Despite progress, challenges remain around data standardization, patient matching accuracy, and the cost of participation for smaller provider organizations.