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      Utilizing a health information exchange to facilitate COVID-19 VA primary care follow-up for Veterans diagnosed in the community

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          Abstract

          The use of alerts from the Bronx RHIO, a health information exchange (HIE) to identify James J. Peters VAMC patients diagnosed with COVID-19 in the community was described to facilitate COVID-19 VA primary care follow-up. COVID-19 hospitalization and testing alerts were delivered on a Bronx RHIO facility report. VA COVID-19 follow-up care by telephone and video was guided by local COVID-19 clinical pathways, electronic health record (EHR) templates, and tracking through a database. VA received 180 RHIO alerts for 111 unique patients, and 88 had positive non-VA testing from March to June 2020. 41% of the 88 had non-VA admissions and 23% died. 63% received VA primary care follow-up of COVID-19 symptoms documented by custom EHR templates. The HIE identified 11% of the facility COVID-19 patients. HIE alerts can be used to identify facility COVID-19 patients diagnosed in the community and facilitate follow-up by their VA primary care teams.

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          Balancing Health Privacy, Health Information Exchange and Research in the Context of the COVID-19 Pandemic

          Abstract The novel coronavirus COVID-19 infection poses serious challenges to the healthcare system that are being addressed through the creation of new unique and advanced systems of care with disjointed care processes (telehealth screening, drive-through specimen collection, remote testing, telehealth management, etc.) However, our current regulations on the flows of information for clinical care and research are antiquated and often conflict at the state and federal level. This paper discusses proposed changes to privacy regulations such as the Health Insurance Portability and Accountability act (HIPAA) designed to let health information seamlessly and frictionlessly flow between the health entities that need to collaborate on treatment of patients and, also, allow it to flow to researchers trying to understand how to limit its impacts.
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            What is Health Information Exchange?

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              Veterans Health Information Exchange: Successes and Challenges of Nationwide Interoperability.

              Health Information Exchange (HIE) between organizations is necessary to have more complete information and coordinate care. Given its nationwide footprint, the Department of Veterans Affairs (VA) connects and exchanges health information with a large number of organizations and consequently has a unique opportunity to experience most issues affecting clinical interoperability. The Veterans HIE Program manages these exchanges by focusing on patient engagement, provider adoption, partner relationship, technology platform, and performance. This paper analyzes the success and challenges of this program over the last five years, and offers valuable metrics and insights. Although significant progress has been made, nationwide interoperability remains fragmented and laborious, requiring multiple agreements and exchange methods. A future nationwide interoperability would embrace a single "on-ramp" to connect to everyone.
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                Author and article information

                Journal
                JAMIA Open
                JAMIA Open
                jamiaoa
                JAMIA Open
                Oxford University Press
                2574-2531
                January 2021
                16 March 2021
                16 March 2021
                : 4
                : 1
                : ooab020
                Affiliations
                Department of Veterans Affairs, James J. Peters Medical Center , Bronx, New York, USA
                Author notes
                Corresponding Author: Rachel L. Sherman, MD, FACP, FAMIA, Department of Veterans Affairs, James J. Peters VA Medical Center, 130 W. Kingsbridge Rd, OOA1, Bronx, New York 10468, USA; Rachel.Sherman@ 123456va.gov
                Author information
                https://orcid.org/0000-0002-4438-6035
                Article
                ooab020
                10.1093/jamiaopen/ooab020
                7962785
                33748690
                e5195612-b4af-4b24-84d5-5ecb9857a689
                Published by Oxford University Press on behalf of the American Medical Informatics Association 2019. This work is written by US Government employees and is in the public domain in the US.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 November 2020
                : 22 January 2021
                : 24 February 2021
                : 05 March 2021
                Page count
                Pages: 4
                Categories
                Brief Communications
                AcademicSubjects/SCI01530
                AcademicSubjects/MED00010
                AcademicSubjects/SCI01060

                health information exchange,covid-19,coronavirus,health information interoperability,veterans health

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