Interoperability and HIE: What the Differences are and How They Contribute to the ENT Healthcare IT Environment

Interoperability and HIE: What the Differences are and How They Contribute to the ENT Healthcare IT Environment

dr_EHR / May 15, 2017

For starters, Interoperability is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged.

Health Information Exchange (HIE) refers to the process that allows two or more systems to exchange information and provides longitudinal access to that information. In its purist form, technology is not a requirement for these systems to operate.

Both these systems will contribute as technology becomes more systematic in the healthcare system. The widespread adoption and use of health IT will require a cultural change whereby patients and ENT providers recognize the value of health IT and come to expect access to electronic health information for both their providers and themselves. This culture change is dependent on a common understanding of what constitutes health IT and how electronic health information is created, stored, accessed, and used.

The Central Role Of Interoperability

Based on the Office of the National Coordinator for Health Information Technology’s (ONC) goal for electronic records to support the nation’s transition from a provider-focused to a patient-focused system of health and care where the result is being the ability to tap into many sources.

Currently, the ability to access multiple sources of information is restricted by at least two shortcomings:

Low rates of health IT adoption within the delivery system that create roadblocks in health-related information sharing, and nebulous standards for exchanging information reliably and securely, whether from where it originates, or where it’s being sent.

Recently, the ENT health care field has begun to understand the multiple problems that exist – from the perspective of both the doctors and patients from these failings of the information exchange. They’ve begun to formulate and execute steps to transition into the adoption of a standard base for the interoperable exchange of information. Widely recognized standards defined by several organizations are facilitating interoperability by requiring the use of them as availability increases.

In order to arrive at the level of sophistication required of EHRs, interoperability must be a pivotal characteristic. In turn, for EHRs to draw information from many sources through health information exchange, those networks of exchange must also be capable of using interoperability’s standards. Thus, electronic records and information exchange processes must be ready to use the increasing number of recognized standards as they become available.

HIE – The Standardized Movement of Health-Related Information

The Health Information Exchange (HIE) is essential to this process. It is the capability to allow two or more systems to exchange information, providing longitudinal access to that information – further enabling interoperability to move forward, while maintaining the security and confidentiality of the information as well as authorization of those who access the information.

HIE systems facilitate the efforts of ENT providers and clinicians to meet high standards of patient care through electronic participation as well as traditional non-technical information exchange methods with multiple providers according to standards, but there are differences within them.

Records are exchanged electronically among providers when they need them. In its purist form, technology is not a requirement for these systems to operate. However, in practice, it is the norm.

Networks that are self-contained, however, such as those linking a hospital to affiliated practices, or to other hospitals in an organization or to labs, can exist without having to employ recognized standards. In the case of networks that make the exchange of information possible solely through proprietary means, the process can result in problems with the exchange of information between the practices, practitioners, hospitals and labs – and of course, the patient.

With HIE, you have 3 METHODS of exchange:


DIRECTED EXCHANGE – Patient has an upcoming visit with an ENT specialist. Here are results of the last visit.

QUERY-BASED EXCHANGE – Please provide the results of the patient’s visit to the ENT specialist.

CONSUMER MEDIATED EXCHANGE – Patient submits information with their own health monitoring and tracking devices through a patient portal.

The goal of HIE is to facilitate access to and retrieval of this clinical data from these different types of exchanges to provide safer and more timely, efficient, effective, and equitable patient-centered care.

The Ultimate Goal for them both?

What’s the ultimate goal? The US Department of Health and Human Services wants interoperability between electronic health records systems (EHRs) from different and often competing vendors to be a common capability by 2024.

The Interoperability Continuum

Electronic Health Records and Health Information Exchanges Need Each Other to Achieve Interoperability.

Health Records Information Exchange ENT

As HIE gradually adheres to Interoperability, and both conform to clearly outlined standard procedures, an EHR can draw from multiple organizations, a comprehensive, longitudinal record of an individual’s pertinent health history. With this complete timeline of detailed records of data, an EHR can instantly offer a perspective on changes in health and medical conditions over time to all of the providers – providing a perfect picture of continuity of care for patients.

For more detailed information about Interoperability and your practice, download our ENT Physician’s Guide to Interoperability – Why it is Important to Your Otolaryngology Practice and Patients.

Download Our Physician's Guide to Interoperability