Frequently Asked Questions

Iowa e-Health is a multi-stakeholder collaboration to improve patient-centered care and population health through the use and exchange of electronic health information. The e-Health Executive Committee, Advisory Council, and workgroups are comprised of diverse stakeholders from public and private entities including health care providers, professional associations, hospitals, government, payers, educators, researchers, and consumers. To support the activities of the Executive Committee, Advisory Council, and the workgroups, the Iowa Department of Public Health formed the Office of Health IT.

Iowa e-Health has been awarded $8,375,000 over four years through a cooperative agreement with the Office of the National Coordinator for Health Information Technology. This funding will support the planning and implementation of the Iowa Health Information Network (IHIN). Other funding from the Centers for Medicare and Medicaid Services and the state of Iowa has been provided to support planning activities.

EHRs are computerized versions of patients’ clinical, demographic and administrative data. The records may include treatment histories, medical test reports and images stored in an electronic format. Although they sometimes are also referred to as electronic medical records (EMR), EHR is now the preferred term because its definition includes the ability to exchange information interoperably while EMR does not necessarily have that ability.

Anything that can be stored on paper medical records can be stored on EHR, but electronic records can be more comprehensive and flexible. For example, a patient’s electronic records could include all of the drugs prescribed to that person and all tests done on that person. They could then be viewed not only in chronological order but also arranged in any other manner, such as charts and graphs, that would allow the patient’s regular physician or any specialist to see trends and changes that could affect that person’s treatment.

Storing health records electronically allows for quicker retrieval of more complete patient information by physicians and other providers. Electronic health records also make searching, tracking and analyzing information easier. Unlike paper records, they are not bulky, they don’t take up costly space and they don’t require labor-intensive methods to maintain, retrieve and file. Electronic health records also provide easier access at times of emergency and can be backed up easily to avoid loss during times of disaster, especially when linked into a health information network.

They can send reminders about scheduled tests, look at all test results over a five-year period and establish better profiles of each patient’s health.

Contact Iowa’s Health Information Technology Regional Extension Center at 800-373-2964.  The Iowa REC has teams of health information technology specialists ready to assist small physician groups in selecting and implementing electronic health records.

An HIE is the electronic movement of health-related information among organizations according to nationally recognized standards. HIE is also sometimes referred to as a health information network (HIN).

Yes, the goal is to offer a complete medical history through the IHIN.  

Providers currently perform auditing of their EHR systems, which will not change due to the IHIN. In addition, Iowa e-Health will monitor the IHIN through different mechanisms to safeguard the privacy and security of the IHIN.

Patient access to the IHIN is being discussed and planned by Iowa e-Health. This may include a web-based portal where patients are able to view information from their providers, or it may include a link to personal health records.

Images (e.g., EKGs, MRIs, etc.) are an option for the IHIN, however this type of service will not be initially available. This is primarily because of the internet bandwidth it takes to transfer those types of images.

When someone needs care in an emergency, that person might be far from home, unable to communicate or unable to remember key information, such as names and doses of prescription drugs. Allowing a physician to retrieve the patient’s records quickly and completely speeds the delivery of appropriate care, and avoids unnecessary duplicative testing, medical errors and extra costs. This is the ultimate goal the federal government has set for 2014.

During such disasters as floods, hurricanes, and wildfires, paper records can be lost or ruined. Electronic health records, however, can be backed up securely and stored in several locations. This permits their retrieval whenever and wherever necessary for medical treatment.

When each physician involved in a patient’s care has all of that patient’s data readily available, medical tests that have already been performed may not have to be repeated unless they are dated or new developments warrant them. This allows the physician to determine further course of treatment more quickly and accurately.

Electronic prescribing, or e-Prescribing, enables a physician to transmit a prescription electronically to a pharmacy. It also enables physicians and pharmacies to obtain information about a patient’s eligibility and medication history from drug plans. In many places, e-Prescribing is the first form of EHR/HIE being adopted.

Yes. The federal government has set a goal for most Americans to have electronic health records by 2014. That goal includes establishing regional and national health information exchange networks that will ensure that complete health information is available for most Americans at the time and place of care, no matter where that is. The system would permit sharing information privately and securely among health care providers when authorized by each patient.

When all of a patient’s health care providers participate in the IHIN, each has access to all the patient’s records, and can make more informed decisions based on complete information. Also, EHR systems can automatically alert health care professionals when there are conflicts between prescribed drugs. In addition, when medical information is stored electronically, problems with illegible handwriting on paper records and prescriptions are eliminated.

The IHIN is not a central depository for health information. The IHIN facilitates exchange of information between EHR systems. The IHIN will not store data, except for the information necessary to identify a patient and locate the patient’s records.

State-of-the-art systems are being employed to secure records to the greatest degree possible and prevent access to unauthorized persons. Any system used must comply with the security provisions of the federal Health Insurance Portability and Accountability Act (HIPAA). HIPAA is the regulatory minimum. States can enact laws and regulations that provide greater protection than HIPAA.

Iowa e-Health has yet to determine the level of patient access, however patient access is important and will be considered as Iowa e-Health begins working with the IHIN vendor.

Iowa e-Health plans to begin with exchanging continuity of care documents, which are summaries of patient records that include demographics, problem lists, recent procedures, allergies, and medications. Additionally, immunization records and lab results will be exchanged through the IHIN. Other services will be added as the IHIN develops.

Health care providers must comply with the data security provisions of the federal Health Insurance Portability and Accountability Act (HIPAA) to protect information in patient records, whether in paper or electronic form. Unlike paper records, EHRs can be encoded so that only authorized individuals can view them.

Patients will have the opportunity to opt-out of the system, so that their information will not be exchanged through the IHIN. Iowa e-Health will develop standards, requirements, policies and procedures for the privacy and security of health information exchanged through the IHIN, consistent with applicable federal and state standards and laws.

The privacy standards in place under HIPAA also apply to electronic health information. As health information networks offer services that directly interface with consumers, additional privacy and security standards will be put into place. State-of-the-art technological safeguards are adopted by networks to protect information in relation to hardware and software operations.

Beginning in January 2011, doctors who have installed an electronic health record system that meets meaningful use criteria will be eligible to begin receiving incentive payments that can total as much as $44,000 in the next five years in increased Medicare payments, and up to $63,750 in additional Medicaid payments.

The longer they wait to install a system, the less money they will receive, and in 2015, doctors will begin to be assessed penalty fees that will increase each year they have not adopted a system.

Meaningful use simply means that the health care provider is using a certified electronic health record system in a meaningful manner. Specifically, they must:

• exchange electronic health information to improve the quality of care
• submit data on clinical quality and other measures
• conduct e-Prescribing

For more information on meaningful use, visit the “Resources” section of this site.