HISP-HISP. What's that?

Last time, we introduced a relatively new acronym, the HISP or Health Information Service Provider. I mentioned that ONC Direct has become the official transmission protocol for protected health information (PHI) passed from one healthcare entity to another. ONC Direct will make use either of a single HISP or of two HISPs (a HISP-to-HISP exchange) if PHI is being shared between providers who use different networks. Let's understand that a little better.


Communications or "portability" of PHI began at the state level not the national level. Every state was funded through the HITECH Act to establish a Health Information Exchange (HIE) and quite a few are already operational. While there may be only one HIE per state, there will be many HISPs, several at least within each state. (Note that some of the operational HIEs today comprise largely hospitals and may have established central repositories of patient data, akin to a secure wide area network or intranet. Since communications were essentially internal to the system, those HIEs may not have been required to use a HISP.)


Large health systems, especially those involving ambulatory care for example, may set up a HISP. You should be aware that some may promote themselves as the only option in your state, especially if your practice falls within that health system's catchment area. This "promotion" may be somewhat covert or assumptive, of course, which is why you need to understand your options. HISPs developed by large health systems may be proprietary in nature and include portal or access fees. It's important to understand how the quest for control is working itself out in your state as health information becomes portable. If you're an independent eye care practitioner, you need to be careful about where and how you tie into your state HIE.


Your state will also be served by HISPs that do not face regional restrictions. Such HISPs are tied neither to large health systems nor to any particular state. It's probable that this type of "pure" HISP will serve the healthcare industry with more open technologies and advanced features and benefits. Remember that the HISP, by definition, handles only the secure transmission of healthcare data, sending and receiving. A good HISP will open doors not restrict or close them.


Interested in learning more about thought leadership around HISPs? Here's one worth checking out, one that's already at the forefront of connecting independent eye care providers to their state HIEs. Secure Exchange Solutions.


So what does HISP-HISP look like for you? Here's an example. Let's say you want to receive a CCD from a primary care physician or another hospital-based provider (because receiving the CCD will mean automatically populating your patient history, problem list, meds list and allergy list). That other provider is most likely tied into a different HISP network than you are, and maybe is part of that large health system. Your referral provider's CCD is sent on his or her system's HISP. Your receipt of that CCD are handled by your HISP. Therefore, one HISP sends, the other receives. That's a HISP-to-HISP communication. In due course, it'll become a daily reality, one that will shorten the length of your patient encounter, helping you see more patients in less time.


Alistair Jackson, M.Ed.