Addressing the Needs of the Texas EHDI Program through the Creation of a Public HIE

The office of the national coordinator (ONC) for Health Information Technology provides leadership to implement a nationwide interoperable information technology infrastructure – a health information exchange (HIE) to improve quality, safety and efficiency of healthcare delivery. The goal is to make records interoperable and digital.  To this end, Texas EHDI (TEHDI), in the Department of State Health Services (DSHS), has recognized the growing need for interoperability and real time access to an infant’s hearing health record by audiologists, physicians and Medical Home providers, and educators; essentially a microcosm of the ONC’s HIE, to assure hearing screening, follow-up, diagnostics and early intervention for children born in Texas.  Like many other states, Texas’ challenges include large emigrant and immigrant populations in rural and urban settings and families dispersed hundreds of miles from services. Because the birth cohort exceeds 410,000, if 3.5% do not pass screening and 3% are not screened statewide, then nearly 30,000 children must be followed and found.  Multiple efforts are underway to tackle these challenges from enhanced training and performance monitoring to the introduction of a mini HIE in the TEDHI information system.  

 This presentation will describe how TEHDI developed an HIE, efforts to reduce and analyze the loss to follow up and loss to documentation rates after expansion of the HIE to include the Medical Home and Early Intervention, the screening and follow up needs the HIE addresses, examples of data exchanged between providers, how privacy and security issues are addressed and comply with local and federal laws, and lessons learned.