Your Medical Information and Health Information Exchanges (HIEs)
It’s not uncommon that the patients we treat receive medical care from many different healthcare providers not all of whom are affiliated with CHOP. Allowing your child’s doctors electronic access to medical information can reduce the chance that your child receives unnecessary or duplicate services, prevent delays in treatment and improve the overall quality of the care for your child.
What is a Health Information Exchange?
A Health Information Exchange (HIE) is a way to share your child’s medical information electronically between all healthcare providers participating in the exchange. Authorized healthcare providers that participate in the exchange may supply your child’s medical information, or receive information about your child.
Which HIEs does CHOP participate in and who has access to these exchanges?
CHOP is just beginning to participate in HIEs, but this participation is expanding. Currently, healthcare providers not affiliated with CHOP are able to have electronic access to the CHOP medical record of their patients (with the patient’s permission where appropriate). Authorized healthcare providers are being added regularly to HIEs in which CHOP participates to better serve our patients. Today CHOP participates in the following HIE arrangements:
- CHOP HIE – This exchange is managed by CHOP. It gives authorized healthcare providers and hospitals (and their staff) who are not affiliated with CHOP access to information from your child’s CHOP medical record with your permission. Some authorized healthcare providers have direct electronic access to your child’s entire CHOP medical record while other healthcare providers can only obtain a care summary document describing your child’s care.
- Virtua HIE – This exchange is managed by Virtua healthcare system. It gives authorized healthcare providers (and their staff) who participate in the exchange, electronic access to your child’s medical information. CHOP and other authorized healthcare providers supply information to the exchange and are able to access information that is in the exchange. This is a list of healthcare providers participating in the Virtua HIE.
- Direct access by CHOP to your child’s electronic medical record at other hospitals – This type of HIE lets CHOP (with your permission where appropriate) have direct electronic access to information about care your child received from another healthcare provider that participates in the exchange.
As CHOP’s participation in other exchanges expands, we’ll update this site. Check back for updates.
What information is available in HIEs?
The following information from your CHOP medical record is available in each of the HIEs in which the Hospital participates:
- CHOP HIE – Generally, all information in your CHOP electronic medical record is available to authorized healthcare providers (and their staff) who certify to CHOP that they are involved in your child’s care. For some healthcare providers, such as hospitals, only care summary documents are available which include basic information like your child’s diagnoses, medications, allergies, lab tests and visit summaries. (See What about my sensitive information? for more details.)
- Virtua HIE – For patients who receive radiological services at Virtua, the information CHOP shares with this exchange is limited to your demographic information (such as name and medical record number) and radiological images from your CHOP electronic medical record (such as X-rays) when you are a patient at both CHOP and Virtua. We’re working with Virtua to expand the scope of the Virtua HIE to allow CHOP and Virtua to electronically request and obtain information about all care delivered to your child. We’ll share more information about this expanded service when it becomes available. Your written permission will be required before your child’s entire CHOP medical record is shared in the expanded Virtua HIE.
- Direct access by CHOP to your electronic medical record at other hospitals – This type of exchange will allow your CHOP healthcare providers (and our support staff) to have direct electronic access to your child’s electronic medical record that is maintained by another healthcare provider who has cared for your child. At some participating hospitals CHOP will be able to access your child’s entire medical record. At other hospitals CHOP will only be able to download a care summary document with basic information about your child’s care such as diagnoses, medications, allergies, lab tests and visit summaries. (See What about my sensitive information? for more details.)
Authorized healthcare providers who have access to your child’s medical information in an exchange will be able to view, print and retain documents from your child’s medical record.
What about my "sensitive" information?
Sensitive medical information about things like alcohol or drug abuse, mental health, HIV/AIDS and genetic information is given special additional protection by state or federal laws. If you agree to allow your child’s medical information to be shared in an HIE, all information in your child’s CHOP electronic medical record, including sensitive information, will be accessible to authorized healthcare providers who participate in the exchange. (There is a limited exception related to mental health provider notes stored in confidential sections of CHOP’s medical record that will not be shared.) Your written permission is required to allow CHOP to share your child’s entire medical record in an HIE.
How will my information be used by HIE healthcare providers?
Medical information obtained by authorized healthcare providers through an HIE may only be used for purposes of providing treatment, obtaining payment, or to perform business operations and other activities allowed or required by law. The CHOP Notice of Privacy Practices explains in detail the purposes for which your medical information can be used by CHOP and your rights regarding your information. Each healthcare provider participating in the exchange is required to have their own Notice of Privacy Practices.
How secure are HIEs?
All healthcare providers are required by law to protect the privacy of medical information. Special security features are used to keep your child’s information secure and prevent medical information from being seen by anyone who is not supposed to have access. For example, data transfers between healthcare providers are encrypted to ensure your child’s medical information cannot be accessed by anyone who is not authorized to view it. If improper access does occur through an HIE, the law requires that you be notified.
Do I have a choice about sharing my medical information in an HIE?
Yes, you have a choice. Details of how you can choose are described below.
- CHOP HIE – You must provide your written permission in order to participate in this HIE because your child’s entire medical record (including sensitive information described above) is electronically available to participating healthcare providers. You will be asked to review and sign a special authorization form to allow electronic access to your child’s CHOP medical record to participate in the CHOP HIE. By signing this form you will also be allowing CHOP to share care summary documents with certain healthcare providers caring for your child (such as some hospitals), in place of your child’s full medical record. Even after you sign this special authorization form, you can change your mind and ask that CHOP no longer allow electronic access to your child’s medical information. If you choose not participate in this exchange, your child can still receive treatment from CHOP. However, healthcare providers caring for your child, who are not affiliated with CHOP, will not have electronic access to your child’s CHOP medical record. CHOP may continue to share information with other healthcare providers caring for your child through existing mechanisms including telephone calls, faxes and mail.
- Virtua HIE – You have the choice to opt out of this HIE. Because the type of information currently shared by CHOP with this HIE is so limited, your information is automatically shared if you receive radiology services at Virtua. If you would like to opt out of the Virtua HIE you can complete, sign and submit this HIE opt-out form or call 1-800-VIRTUA-3.
How do I sign up or opt-out?
- CHOP HIE – You can contact any CHOP physician caring for your child or any CHOP registration area. To participate, you will be asked to sign a special authorization form to allow your child’s information to be shared in this HIE. If you already signed up and have changed your mind, you can ask that your child’s information not be shared any longer in this HIE
- Virtua HIE – You do not need to do anything to sign up. Information about your child’s radiology services is automatically shared with the Virtua HIE and accessible to HIE participants unless you decide to opt out using the Virtua HIE opt-out form or calling 1-800-VIRTUA-3.
Who do I contact for more information?
If you have additional questions about CHOP’s HIE activities please contact us online.