The GAO is required to conduct reviews of these exchanges under the Health Information Technology for Economic and Clinical Health Act, or HITECH, portion of the American Recovery and Reinvestment Act signed by President Barack Obama in 2009.
The idea is to make sure that the practices that are in place for disclosing sensitive personal health information are being followed properly, and study what the effect has been of sharing such information among providers.
Two exchanges reported to the GAO that by coordinating information sharing between hospitals and local public health departments, they have been able to improve early detection of disease outbreaks. One official said the exchange helped the state to obtain H1N1 case data more quickly than other states, according to the GAO report.
Data-sharing also helped save lives, participants reported. One large hospital reported that a cardiologist was able to get an abnormal test result electronically through the exchange for a patient a day earlier than would have been possible without the exchange. As a result, the provider was able to give patients the care they needed in a timely manner for a potentially life-threatening condition.
The exchanges also helped thwart patient abuse of a fragmented healthcare system. One hospital reported that an emergency department physician was able to access patient records through the exchange and learn that a particular patient had visited five area hospitals over seven nights seeking pain medication. The physician refrained from prescribing further pain drugs to this patient, the GAO reported.
The four HIEs were not identified by name or state. And they varied in terms of their size and maturity. The oldest exchange profiled by the GAO was formed in 1995, while the newest launched in 2007. The two others started in 2005 and 2007.
Two of the exchanges operate in just one state, while two others operate across state lines. One exchange has just one hospital and three participating provider practices. Another has 39 hospitals and 4,240 practices.
The GAO collected information for the report between May 2009 and February 2010. There are more than 60 HIEs in operation nationwide.
In conclusion, the GAO reported that participants were adhering to patient privacy rules.
“Both the providers and exchanges in the study described practices that limit disclosure of information, secure electronic information that they store and transmit, and help ensure accountability for safeguarding electronic personal health information,” the GAO concluded in the report.
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