Florida Health Information Exchange: A Journey to Improving Care through the Exchange of Patient Health Information

Florida Health Information Exchange: A Journey to Improving Care through the Exchange of Patient Health Information

Alice Noblin (University of Central Florida, USA), Kelly McLendon (Health Information Xperts, USA) and Steven Shim (Harris IT Services, USA)
DOI: 10.4018/978-1-4666-2671-3.ch010


Florida began the journey to health information connectivity in 2004 under Governor Jeb Bush. Initially these efforts were funded by grants, but due to the downturn in the economy, the state was unable to support growth in 2008. The American Recovery and Reinvestment Act of 2009 provided funding to further expand health information exchange efforts across the country. As a result, Florida is now able to move forward and make progress in information sharing. Harris Corporation was contracted to provide some basic services to the health care industry in 2011. However, challenges remain as privacy and security regulations are put in place to protect patients’ information. With two seemingly opposing mandates, sharing the information versus protecting the information, challenges continue to impede progress.
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Organization Background

Efforts toward building a Health Information Exchange (HIE) in Florida began in 2004. The Agency for Health Care Administration (AHCA) laid the foundation for a statewide HIE by organizing health care stakeholders and providing initial funding to local Regional Health Information Organization (RHIO) projects through its grants program. Florida is working to achieve a secure and sustainable approach to health information technology adoption and exchange resulting in better health care outcomes with lowered total costs. The development of a HIE that protects privacy and aligns with national exchange standards is the goal of AHCA. Leveraging existing networks to best achieve widespread adoption is one way to achieve the goal. In 2010, the Office of the National Coordinator for Health Information Technology (ONC) provided grant funds to significantly advance Florida’s plans to build a statewide health information infrastructure. The provision of sustainable services to meet the meaningful use criteria established by ONC is an important focus of the HIE.

Key services to be implemented include:

  • A patient look-up service

  • A provider directory

  • Secure messaging

  • Public health reporting

This case study aims to describe the historical journey of the HIE in the State of Florida from 2004 to the present. Significant financial resources from the stimulus package in 2010 have allowed the HIE to move forward by providing the key services above to allow sharing of patient data. As has occurred throughout the nation, privacy concerns have been at the forefront of all networking efforts in Florida. In addition to describing the current structure and services available, we will chronicle the ongoing efforts to create and maintain the processes of privacy and security compliance which will ultimately improve user confidence in the HIE.


Setting The Stage

Health Information Exchange within the State of Florida began as an Executive Order from Governor Jeb Bush in May, 2004. Governor Bush established an advisory board (Governor’s Health Information Infrastructure Advisory Board [GHIIAB]) to advise AHCA in the creation and implementation of a Florida Health Information Technology (HIT) infrastructure (Greaves, et al., 2007). In addition to supporting local data exchanges (RHIOs), the state was working on development of an overarching network to bring the local exchanges together, which has become the current HIE.

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