Not too long ago, health information exchange - the verb, not the noun - was something someone else had to worry about. It was complicated, sometimes contentious. But many providers could sleep well, comforted by the fact that it was large hospitals and academic medical centers - not them - who were the ones dealing with it.
Everyone from Office of the National Coordinator on down have been paying close attention to parts of speech when it comes to health information exchange lately. Quoth Farzad Mostashari, MD: "I refuse to speak of HIE as a noun. HIE is a verb."
But no question, the mechanisms of HIE are very much nouns - and very different types of nouns, at that.
There are private HIEs: "I'm the hospital and we own a bunch of doc practices and some of them run one brand and some of them run another, and we bring their data into a central repository," says Hoyt. There are public HIEs: "There is some sort of a neutral entity to which we all subscribe somehow, and we send the data to it - it's the broker, it sends it to the requesting organization, or to all organizations."
There's also a third category, "which has been around for a while," says Hoyt. "I'd argue that it's not quite in the spirit of what health information exchange is. It's organizations who electronically participate, by law in some immunization registry or disease registry."