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eHealth Exchange- Connecting Nationally

eHealth Exchange – Connecting Nationally

WISHIN is your on-ramp to the eHealth Exchange.

The eHealth Exchange is a network of providers, hospitals, HIEs (like WISHIN), federal agencies, etc., that share clinical information (care summaries) using a secure, standardized approach.  There are currently more than 90 participants spanning all 50 states that share information via the eHealth Exchange- the national “highway” for electronically sharing health information.


Becoming an eHealth Exchange participant takes some work, and requires more than a few resources.  It means signing a legal agreement, completing testing to show compliance with technical standards, and paying an initial fee and ongoing annual fees. 


The good news is that WISHIN Pulse participants can skip all of the legal, technical, and financial requirements for onboarding directly to the eHealth Exchange because WISHIN has already completed the work on behalf of its participants . WISHIN's participation in the eHealth Exchange extends to all WISHIN Pulse participants; individual organizations do not need to onboard to the eHealth Exchange directly in order to reap the benefits. 


Participation in the eHealth Exchange is important for purposes of Meaningful Use (MU) compliance.  Under MU, care summaries must be electronically shared via Direct Messaging (e.g., WISHIN Direct+) or through an organization that is a participant in the eHealth Exchange (WISHIN Pulse). 


At a practical level, WISHIN's participation in the eHealth Exchange provides some key benefits to WISHIN Pulse participants, including:

1. Automatically Query the eHealth Exchange

When WISHIN Pulse is queried for clinical data (care summaries) on a patient from within a provider’s EHR, all WISHIN Pulse participants are automatically queried as well as all eHealth Exchange participants that WISHIN has configured.  A provider doesn’t have to know the specific organization they want  to query,  they just point it to WISHIN and the rest is done automatically.  WISHIN won't query every eHealth Exchange participant (that's against the rules) - but it will query key participants in Wisconsin’s border states, other state HIEs, participants that commonly share patients with WISHIN participants, and participants in snowbird states like Florida and Arizona.  Who WISHIN queries on the eHealth Exchange is configurable - so WISHIN can add to it easily and quickly at any time.


And don't worry: even though WISHIN queries all those eHealth Exchange participants, providers will only get care summaries from those that have care summaries on the patient.  So if the patient has never received care from an eHealth Exchange participant, the query will return data only from other WISHIN Pulse participants. But if they did receive care from an eHealth Exchange participant outside of Wisconsin, WISHIN Pulse will show you that data too.

When a provider queries WISHIN from its EHR, they do not need to know which WISHIN participant OR which eHealth Exchange participant the patient received care from in order to perform the query and provide you with the clinical data you need.  Some systems require this; WISHIN does not.  All a provider needs to do is query WISHIN.  WISHIN handles the rest.

One other point that bears noting, the eHealth Exchange is a gateway for sharing care summaries only.  So while WISHIN Pulse can provide other types of clinical data (EKGs, radiology reports, lab results, etc.) the eHealth Exchange only supports the exchange of care summaries, which may include those kinds of data, but are not guaranteed to do so.  

2. SSA Disability Determination

Soon, WISHIN's eHealth Exchange participation will allow the Social Security Administration (SSA) to query WISHIN Pulse participants in order to get the clinical data (in the form of care summaries) necessary for disability determination.  According to the SSA, its ability to get the care summaries electronically significantly reduces the amount of time it takes to get a determination on disability from weeks and months in the current paper-based process, down to hours and days via HIE!


A faster turnaround on disability determination can mean that coverage becomes effective sooner, which can help avoid delays in care that can result in more serious conditions requiring more expensive treatments.  It also means claims can be processed sooner. 

The SSA functionality only works with care summaries.  This means that WISHIN participants must be sharing care summaries with the WISHIN Pulse network in order to use it. 

The care summaries required by the SSA for disability determination are the standard CCDA care summaries supported by all EHRs with 2014 Certified Electronic Health Record Technology (aka 2014 CEHRT). This means that providers participating in Stage 2 of the Meaningful Use Incentive Program and  using a 2014 CEHRT EHR, are already producing the care summaries out of their EHR that the SSA needs to do disability determination.   There's no extra data needed in them.  There's no special format.  Nothing different.  And while an EHR vendor may tell a provider that they have something "special" or "custom" that the SSA likes, it simply isn't required. The SSA expects the same thing from every EHR; it doesn't change its requirements by EHR vendor.   And yes, we've confirmed that directly with the SSA.

If a provider’s EHR isn't 2014 CEHRT WISHIN may have to work with the provider and its EHR vendor to get the care summaries in the correct format - but that's why WISHIN is here. 

One last note on this topic, and it's important: The SSA is paying WISHIN for every care summary it uses via this functionality and WISHIN will be sharing this revenue with WISHIN participants that enable this service.  This means that in addition to the savings providers will realize by not having to process the SSA requests manually, they’ll also be receiving payment for the care summaries they provide to the SSA through WISHIN Pulse. 


3. Veterans Administration (VA) Access

WISHIN's eHealth Exchange participation will also allow WISHIN Pulse participants to exchange health information (care summaries) with the Veterans Administration. Many veterans see VA and non-VA health care providers, which can make it difficult for providers to access the records they need to manage a veteran's care.  The VLER (Virtual Lifetime Electronic Record) Health Exchange allows non-VA providers to securely view certain veteran health information through the eHealth Exchange. 

For WISHIN participants that treat veterans, this functionality will give them access to care summary information from the VA and from non-VA providers.

Once the VA supports care summaries in the CCDA format WISHIN will be able to finalize the process with the VA and use its eHealth Exchange participation for exchanging Veteran health information with VA and non-VA providers.

4. Meaningful Use: Transitions of Care

As a WISHIN Pulse participant, organizations can also meet the Meaningful Use Transitions of Care objective by sharing care summaries via WISHIN Pulse. While many providers may be sharing care summaries using Direct messaging or through theirEHR vendor's proprietary solution the objective can also be met by participating in a health information exchange, as long as that HIE is an eHealth Exchange participant like WISHIN is with WISHIN Pulse. 


All of these benefits are available to WISHIN Pulse participants without the time, expense and labor of separately onboarding to the eHealth Exchange.