Health Data Exchange (HIE) may be defined as the electronic exchange of specific health-related information between medical facilities with the use of nationally recognized and generally accepted standards. It goes without saying that the implementation of HIE has multiple considerable benefits. For instance, the health information electronic movement has a great potential to improve the general quality of health care delivery, its effectiveness and efficiency, and patient safety. In addition, HIE may facilitate communication between health care providers, reduce health care costs, minimize health care errors, and improve public health control.
HIE is directly connected with the term interoperability defined as the “ability of two or more systems or components to exchange information and to use the information that has been exchanged” (Benson & Grieve, 2016, p. 20). In the health care system, HIE also refers to all types of interoperability, including technical, semantic, process, and clinical interoperability (Benson & Grieve, 2016). For example, if a mother with a newborn is discharged from the hospital following birth and subsequently referred to a pediatric clinic for surveillance and follow-up, her patient data and the child’s data should be accurately transferred between medical facilities.
In general, interoperability is an immeasurably complex process, which volumes are even hard to imagine – only one large hospital may process several million HL7 messages per day (Benson & Grieve, 2016). That is why it goes without saying that the standards of this process in relation to the system and its segments should be discussed and agreed in order to avoid confusion and data variability. The significance of this agreement is additionally determined by the fact that “every type of computer system stores data internally in a different way” (Benson & Grieve, 2016, p. 24). That is why every information transaction should be defined in unambiguous, stringent detail being a part of a consistent, coherent, computer-readable, and complete set of specifications.
Along with the unique way of every medical facility’s working and thinking, variability and, as a result, errors may be caused by the heterogeneity of information in the case of the absence of commonly accepted variants. Information details of thousands of patients may vary and a medical facility does not have enough resources to check every record before transmission (Benson & Grieve, 2016). For instance, concerning the woman with the child mentioned above, she may have several addresses and use either her maiden or married name for different records. These facts support the necessity of common agreement upon information and the system’s segments as well.
As a matter of fact, HL7 segments are the groups of fields that contain different types of data. The main segments include the message header (MSH), patient identification details (PID), event type (EVN), request and specimen details (OBR), patent visit (PV1), and result details (OBX), and Z-segments (Benson & Grieve, 2016). Both sending and receiving systems should be in agreement with each segment’s content as unexpected segments may cause considerable issues within a receiving system, misunderstanding, and malpractice. That is why the consequences of segments, HL7 structure, and data types should be standardized by organizations before the implementation of HIE. For instance, stakeholders should agree to use only the patient’s NHS number instead of a Patient internal identifier, married name (in the case of female patients), residence address, and the unified standard of analyses’ documentation.
Reference
Benson, T., & Grieve, G. (2016). Principles of health interoperability: SNOMED CT, HL7 and FHIR (3rd ed.). Springer.