Indiana Health Information Exchange

The Indiana Health Information Exchange (IHIE) is a non-profit health information exchange (HIE) located in Indianapolis, Indiana. It serves a large percentage of hospitals across the state of Indiana and was one of the first HIEs introduced.

History

Inception

IHIE was formed in 1996 with the alliance of the five largest hospital groups in Indianapolis and initially created as the Indiana Network for Patient Care (INPC), a data sharing collaborative that at its formation primarily focused on patient seen in the emergency departments (EDs) of the hospitals in each of the hospital groups. The INPC was originally created and supported by the Regenstrief Institute.

Departure from Regenstrief

In 2004, IHIE was officially incorporated as a non-profit organization separate from Regenstrief. While the two organizations freely share data and software, the ongoing maintenance of the INPC and its related services falls to IHIE.

Core Features

IHIE has a number of core features that enable its services. As a requirement of participation, all institutions must agree to freely sharing their data among other participating parties, maximizing the data access for all involved.

Data Sources and Mapping

IHIE receives an HL7 feed from each of its participating institutions which is stored in the INPC (see below). As data flows, it is normalized and mapped to allow the data to be compared and trended with data from other participating members. This is accomplished by assigning a standardized Regenstrief term (each term associated with a corresponding LOINC code) to each result. A lab mapping team monitors codes that fail to be assigned and works to create new Regenstrief terms as needed for unmapped terms.

Patient Matching

As data is collected, a key feature enabling interoperability is patient name matching. This involves the use of patient matching algorithms, many of which were developed initially at Regenstrief.

Data Repositories

The Indiana Network for Patient Care (INPC)

The INPC was the initial data repository at the founding of IHIE, and it remains the primary source of clinical data in the system. As of 2011, the repository had "over 3 billion discrete results, including 840 million encounters, 1.7 billion clinical observations, and 580 million claims observations (procedures, prescriptions, etc)."

INPC-R

Despite IHIE and Regenstrief being separate entities, the two enjoy a rich research and data sharing relationship. The INPC-R was created to provide Regenstrief with its own repository of clinical data for the purposes of research.

Clinical Platforms

DOCS4DOCS

DOCS4DOCS was the first product introduced by IHIE upon its incorporation in 2004 to fulfill the need of physicians to monitor their patients across facilities. The platform has grown tremendously and now covers physicians in over 100 hospitals and clinics throughout the state of Indiana. Supported documents include admission/discharge summaries, lab and radiology results, cardiology studies, and continuity of care documents (CCDs). Modalities of transmission include fax, e-mail, web access, and HL7. Support for FHIR is in process, eventually enabling the push of results to the electronic health record of the patient's primary hospital system.

CareWeb

As the popularity of DOCS4DOCS increased and with it the awareness that patient data from outside sources could be accessed, demand grew for a similar application that could be used by providers other than a patient's primary physician. Emergency departments in particular were interested in accessing this data as patients often present to EDs outside their usual hospital network. This interest led to the creation of CareWeb, a resource available to any facility that is part of the IHIE network. Data including lab and ancillary testing results can be trended across institutions.