Understanding the Basics of Health Information Exchange

A person’s healthcare story rarely happens in one place. 

They might see a family doctor in a small clinic, end up in the emergency department of a major hospital, then follow up with a specialist the next town over. And while every one of those providers needs accurate and timely information, they’re often working in different systems, with different workflows, and sometimes entirely different organizations. 

So how does it all come together?

That’s the question Health Information Exchange (HIE) tries to answer. 

You’ve probably heard the term before. It often comes up in conversations about interoperability, continuity of care, or national health strategies. But what’s easy to miss is that HIE isn’t just a single system or one-time project. It’s a blend of processes, standards, and infrastructure designed to help health data move between organizations—securely, appropriately, and ideally, with purpose.

That doesn’t always happen as cleanly as we’d like. But when it works, it helps bridge the information gaps when patients receive care in multiple places. 

Health Information Exchange refers to data sharing between organizations—like a hospital and a primary care clinic—not just between departments or systems inside a single health system.

So what does HIE look like in practice?

Most people think of HIE as the ability to send and receive patient summaries—and that’s not wrong. Many exchanges revolve around clinical documents like discharge summaries, diagnostic results, and medication lists. But HIE can also mean:

📨 Secure messaging between providers
📫 Notifications about admissions or discharges
🔎 One system querying another for a patient’s health history
📋 Sharing of care plans, allergy lists, or immunization records

Some models push data directly—others rely on a query or lookup. And in more advanced setups, patients may even control how, when, and with whom their data is shared. The technical approach varies, but the goal is the same: help clinicians and care teams make more informed decisions, no matter where the patient was seen before.

Who’s in—and who’s missing?

If you’ve worked in a hospital or clinic that participates in a regional or national HIE, you’ve likely seen the benefits: fewer duplicate tests, faster access to outside records, and more informed decisions. 

But participation isn’t universal. 

While hospitals and large health systems are usually connected, smaller clinics, long-term care homes, and private providers aren’t always included. Sometimes the barriers are technical. Other times, it’s about policy, cost, or consent. And even when a connection exists, that doesn’t mean all data types are available or timely.

As health IT professionals, it’s important to know what’s flowing, what’s not, and where the blind spots are—because they’re not always obvious to end users.

What’s happening behind the scenes?

Getting health information to move between systems isn’t just about wiring them together. For exchange to work, several things need to be in place:

✔️ Common data standards (e.g., HL7 v2, C-CDA, FHIR)
✔️ Patient identity matching (often with a Master Patient Index)
✔️ Record locator services to know where data lives
✔️ Strong security and governance policies

Even when these technical pieces align, there’s another challenge: integration into real workflows. If clinicians have to launch a separate viewer, dig through pages of unfiltered data, or click dozens of times to get at information, the value of the HIE drops fast. 

Is it a perfect solution? Not quite.

There’s a lot to like about HIE. It supports coordination, reduces duplication, and brings context to decisions that span multiple care settings. It helps close the gaps between providers who don’t share systems—and sometimes, don’t even know each other.  

But it’s not magic. 

HIE doesn’t correct inconsistent documentation or clean up poor data entry. And it won’t resolve conflicting information or interpret clinical nuance. 

What it offers is a foundation—a way to make more information available when and where it’s needed, so people caring for a patient have a more comprehensive view.  

If your organization shares or receives data from others, someone is making decisions about what gets exchanged, how it’s used, and what it looks like on the other side. That someone might be you—or someone you’re supporting.

👀 Curious how other health IT professionals are navigating this space?

Join the Draegan Network to connect with peers, ask questions, and share your experience. Because understanding HIE is just the beginning. Making it meaningful takes all of us.