health information exchange (HIE) Directions: Please read first and then respond to their questions in a simple paragraph to each one bellow (separate) #1 through #5 SUBSTANTIVE 1 full paragraph on each of the responses (separately) ¢ Greet a specific student or a group of fellow students by name. ¢ Put key concepts in own words and provide unique examples ¢Add substantive information, asks meaningful questions to peers and provides substantive responses ¢Draw insightful conclusions that are thoroughly defended Write responses that can be easily understood and are clear and concise ¢ Clearly identify the source of information and evidence that you do use. ¢ Include detail from our text and common reading as evidence for what you have to say (Remember that others will need to draw on our readings, too, so only use just enough information from our readings to make your point clearly). #1. Kayla, The existence of health information exchange (HIE) and health insurance exchange (HIX) are both highly important to fulfilling affordable care act guidelines. HIE’s existence will allow for individual’s medical records to be shared from provider to provider, creating more continuity of care of that individual. This will subsequently save time and money for the patient and provider which is a huge benefit. The existence of the HIX is a step in a positive direction. HIX creates an initial baseline platform in each state for a majority of American’s to receive affordable health insurance in our country, largely a benefit. Both systems, still in their infancy, have flaws and kinks that will hopefully be worked out over time. The primary risk associated with HIE is the security of patient medical records, the ability to share records also opens records to the world of less secure servers and hackers. The major risk associated with HIX is that, because each state is responsible for its own HIX, each state’s baseline coverage may vary. This could be confusing for those that live near a state border and potentially need to seek treatment in a neighboring state. All in all HIE and HIX existence is a step in a positive direction for the changes associated with the Affordable Care Act. #2. Elizabeth, I do believe that HIE/HIX are important tools to the healthcare industry. Health information exchanges (HIE) are used by medical providers to exchange health information with other providers in a secure manner (PA E-Health, n.d.). Essentially HIEs can assist in making the care coordination of a patient into a seamless process. This is extremely important to the future of the industry! Not only this, but using EHR systems amongst providers is a proven method to increase efficiency: a 2011 study done by the New England Journal of Medicine “documented the improved delivery if healthcare between doctors that sued EHR systems versus those that did not” (PA E-Health, n.d.). With HIE systems, a patient’s care team in a given geographic region can have access to virtually the same information, therefore making it easier to care for the patient. Health insurance exchanges (HIX) are an outlet for patients pursuing health insurance, and are considered virtual marketplaces. States are expected to establish and run these marketplaces by 2014, and those states without marketplaces will be controlled by the Federal government (CMS, 2013). The purpose of the HIX idea is to make health insurance more easily available and affordable to consumers. Consumers in all states will be able to purchase insurance from a set list of qualified providers, and around 18 million Americans may also find that they are eligible for tax credits to help pay for their insurance (CMS, 2013). HIX systems are a great idea, and will likely inspire more Americans to invest in health insurance. There are benefits to HIE/HIX systems as well as downfalls. The largest benefit is that these systems can help increase efficiency of the delivery of healthcare. Similarly, it can be very cost effective to utilize online exchange systems, both for the patient and the provider. However, one downfall is that there is a risk of information being received by an unauthorized party. For example, if information is being sent to several providers via a HIE system and it accidentally is sent someone outside of the care team. It is important to only utilize certified systems. However, it is safe to say that HIE/HIX systems are the way of the future for the healthcare industry in the United States. #3. Kristen, I support that EBM provides physicians evidence and data to make well informed and educated decisions. However, by strictly sticking to EBM, I believe that we lose a little bit of what physicians are trained to do “ have a hunch and put the interest of the patient first. Although it is certainly not founded with true hard facts, but I have seen it first hand where data and numbers were pointing to a terrible outcome and labeling a situation as very dangerous. Then, whether it be miracle or an unforeseen factor, the patient miraculously rebounds. Sometimes there really is no rhyme, reason, or data that can support what happened, but also just sometimes, a doctor has a “sixth sense” about it. Physicians should integrate EBM into their practice and treatments, but they should also stay confident in their gut feelings, after all, that is usually a motivator for them becoming a physician anyways, isn’t it? To answer the discussion question, yes “ I do believe EBM can or could transcend a physician’s practice but it could also remove a natural and human element of medicine if a EBM is used too strictly. #4. Chau Evidence-based health care (EBM) is the conscientious use of current best evidence in making decisions about the care of individual patients. (BMJ, 2005). Basically EBM is the process of systematically reviewing, appraising and using clinical research findings to aid the delivery of optimum clinical care to patients. In response the question, I do support the assertion that EBM will go beyond the range of what medical physicians do because so many physicians are not taking patient life seriously. They only follow protocol and ignore what they think is wrong, which results in consequences. With the implement of EBM, it gives physicians a much more strict discipline so any misuse or miscommunication can be eliminated. Physicians aren’t just giving out medications because they think it helps or cure the patient; with EBM it gives the physicians much more confident, safe, and the justification of their research before giving the practice/medication. So overall, I do believe this will continue to evolve in the future as well as today. #5. Krystle, Yes, I do support the statement that evidence based medicine will transcend what physicians do. If the practice of medicine adheres wholly to the use of clinical practice guidelines to aid in medical decision making, all parties involved in the patient’s medical care will need to be educated in using these guidelines. The guidelines can be thought of as a medical team’s playbook. The physician may be like the quarterback, calling the plays for treatment, but the nurses and therapists are like the running backs and wide receivers, carrying out the plays. The use of EBM however, I feel must be used in conjunction with sound judgment. According to Loewy, œif we are to use EBM humanely and efficiently, we would be compelled, I think, to allow physicians within reason to ˜play their hunches’ œ(Loewy, 2007). Physicians, when calling plays, should have a familiarity with the patient’s defenses, their support team and their strengths. This allows them to factor these important elements into the medical decision making, even if it goes against what the playbook calls for.