A paper published in the Annals of Emergency Medicine offers recommendations for improving a national health information exchange (HIE) that would improve the state of emergency medicine.

The paper includes suggestions from an American College of Emergency Physicians work group and lists the following five primary recommendations:

• Care standards and protocols for integrating HIE use in ED settings should be developed;
• ED physicians should participate in regional and federal health information exchange-related activities to appropriately represent their interests;
• Federal regulatory and legislative measures must support a set of HIE standards that includes and prioritizes elements relevant to emergency care; 
• Local professional groups should provide appropriate data for emergency physicians and should consider performing pilots with HIE to boost the focus on emergency care; and
• Policies should be developed regarding the standard of care for review and inclusion of HIE data in EHRs in emergency care settings.

Since patients receive care at several locations, their complete health information usually isn't available at the point of care. "Significant changes are needed to support a system of effective national HIE that can rapidly and efficiently yield useful health information to health care providers in emergency departments," wrote co-author Jason Shapiro, MD, of the Icahn School of Medicine at Mount Sinai in New York City. "These changes should include support for emergency physician access to all relevant patient information in a properly summarized and understandable form."

The paper also includes secondary recommendations such as enhanced patient matching; HIE funding dedicated to infrastructure development, research and HIE operational sustainability; reporting of adoption and usage data; and better understanding of the value of HIE.