Sharlyne S.

Carris

Knowledge Activity: Health Information

Exchange (Associate)
Student instructions
1. If you have questions about this activity, please contact your instructor for assistance.
2. You will review a de-identified chart to complete this activity. Your instructor has
provided you with a link to the Health Information Exchange (AS) activity. Click on 2:
Launch EHR to review the patient chart and begin this activity.
3. Refer to the patient chart and any suggested resources to complete this activity.
4. Document your answers directly on this activity document as you complete the activity.
When you are finished, you will save this activity document to your device and upload
this activity document with your answers to your Learning Management System (LMS).

Glossary
Continuity of Care Record (CCR): A snapshot in time of relevant medical information, or data
about a specific condition, that can be transferred as part of a health information exchange
organization. (Corepoint Health, 2016)
Health Information Exchange forms: HIEs typically have one of three forms; Directed
Exchange, Query-based Exchange and Consumer Mediated Exchange. The choice of
architecture is driven by the organizations’ privacy and security practices. (AHIMA, 2019)
Consumer Mediated Exchange: provides patients with the ability to combine and
control the use of their health information among multiple providers
Directed Exchange: enables providers to electronically send and receive secure patient
information between care providers in an effort to improve and enable coordinated care
of the patient
Query-based Exchange: enables providers to locate and/or request patient information
on a patient in their care from the patient’s other providers. Query-based Exchange is
often used for unplanned care

EHR Go Knowledge Activity: Health Information Exchange (Associate) HAK1012.4

Archetype Innovations LLC ©2022 1
 The activity
You have been asked by the Central Clinic’s executive committee to perform a review and audit
of the HIE organization that exists between the Central Clinic and the Lakeview Pharmacy. In
the current HIE model, the Lakeview Pharmacy only has access to the Pharmacy section of the
chart. To view what the Lakeview Pharmacy staff can see, click on the Pharmacy section of the
chart found on the left-hand side.
The Pharmacist view under the Pharmacy section includes the Patient Profile, Med Profile, Rx
Processing, and Inpt Processing tabs. This area allows Lakeview Pharmacy to view medication
orders along with basic patient information, including demographics and current problems,
allergies, labs, and vitals.
The Clinician view under the Health section includes many tabs, from the Overview tab down to
the Labs tab. Click on the Health section of the chart found on the left-hand side to view what
the Central Clinic staff can see.
Using the additional resources provided with this activity and the de-identified patient EHR,
answer the questions below.

Questions
1. The Central Clinic utilizes a Directed Exchange model of health information exchange
with the Lakeview Pharmacy. What does this mean? Hint: review the Glossary section
above.
Part of the HIE data shared from the Central Clinic to the Lakeview Pharmacy is the Patient
Profile tab found under the Pharmacy section of the EHR. Refer to the resource Understanding
the Continuity of Care Record found under 1: Overview & Resources of this activity and answer
the following questions.

2. Which of the following statements about the Continuity of Care Record (CCR) is true?
a. The CCR was developed as a longitudinal health history for the patient.
b. The CCR is a type of personal health record (PHR) created and maintained by the
patient for continuity of care.
c. The CCR helps practitioners determine what information is most relevant in the
health of the patient at a moment in time.
d. The CCR should not be used for transitions of care.
3. Is the following statement True or False? The CCR helps solve the problem of health
information exchange and health information portability.

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 a. True
b. False
Click on the Pharmacy section on the left side of the EHR and refer to the information found on
the Patient Profile tab display only. Identify the CCR information included in the HIE. Hint:
These core data sets are defined on page 5 of the resource Understanding the Continuity of
Care Record.

4. CCR identifier or header: Does the EHR contain this data when on the Patient Profile tab
of the Pharmacy section? Answer Yes {if all information is present) or No (if information
is missing or not all
information is present). Provide rationale for your answer.
a. Yes
b. No
5. Patient identifying information: Does the EHR contain any patient identifying
information when on the Patient Profile tab of the Pharmacy section? Choose Answer
Yes (if any patient identifying information is present) or No (if there is no patient
identifying information present). Provide rationale for your answer.
a. Yes
b. No
6. Basic financial/insurance data: Does the EHR contain this data when on the Patient
Profile tab of the Pharmacy section? Answer Yes {if all information is present) or No (if
information is missing or not all information is present). Provide rationale for your
answer.
a. Yes
b. No
7. Advance directives: Does the EHR contain this data when on the Patient Profile tab of
the Pharmacy section? Answer Yes {if all information is present) or No (if information is
missing or not all information is present). Provide rationale for your answer.
a. Yes
b. No
Patient health status: Does the EHR contain the following data elements when on the Patient
Profile tab of the Pharmacy section? Answer with yes (if complete) and no (if missing or
incomplete). Explain your answers. Hint: These core data sets are defined on page 5 of the
resource Understanding the Continuity of Care Record. (Corepoint Health, 2016)

8. Diagnoses, problems, and conditions

Yes, included in the HER, can be found under the problem tab.

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 9. Adverse reactions and alerts list allergies by agent and symptom
Sulfa, is listed as an allergy but no symptoms are included.

10. List of current medications including name, code, dose, schedule/refill dates, prescribing
provider, and comments. No

11. Comprehensive immunizations documentation including dates and disease identifier. No

12. Vital signs information, including readings and date signs were taken
Yes
13. Laboratory results information
Yes, Labs are Included
14. Procedures/assessments information including description, dates, times, locations, and
codes. No
15. Health status section for optional greater details at the discretion of the provider.
No
16. Care documentation: Does the EHR contain this data when on the Patient Profile of the
Pharmacy section? Answer Yes {if all information is present) or No (if information is
missing or not all information is present). Provide rationale for your answer.
a. Yes
b. No

17. Care Plan Recommendations: Does the EHR contain this data when on the Patient
Profile tab of the Pharmacy section? Answer Yes {if all information is present) or No (if
information is missing or not all information is present). Provide rationale for your
answer.
a. Yes
b. No

18. Practitioners: Does the EHR contain this data when on the Patient Profile tab of the
Pharmacy section? Answer Yes {if all information is present) or No (if information is
missing or not all information is present). Provide rationale for your answer.
a. Yes
b. No
Applying HIE and the CCR in practice. In the de-identified patient chart provided for your
review, a prescription for a new medication was placed in the Central Clinic through the Health
section of the EHR today and submitted via the HIE organization to the Pharmacy section of the
EHR. Please locate this prescription order from today and answer the following questions.

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 19. What is the prescription written for? Quinidine Sulfate 200MG Oral Tablet

20. Which provider wrote this prescription and ordered this medication? Ji-Young Sun, MD

21. What is the current status of this prescription? Order contraindicated and flagged

22. What is the reason for this status, according to the Notes under the Order Details for
the medication? Order contraindicated and not filled

23. Click on the envelope icon to view the system alert message from the Pharmacy. (This
message can be accessed via the envelope in the patient information bar at the top of
the EHR.) What type of message is in the inbox? Urgent: Critical Drug-Drug Interaction

24. What does the system alert message say? The system identifies a potential critical drug-
drug interaction between one or more ordered medications in EHR MRXXXXX. Exist a
critical interaction between flagged drug order Quinidine and active drug Digoxin. Order
for Quinidine “Will not be filled” as written. Please contact pharmacy for more details or
information.
25. Based on your review of the de-identified EHR, the HIE organization between the
Central Clinic and the Lakeview Pharmacy, and the CCR data shared through the HIE,
describe step-by-step how the prescription order data sharing occurred for the new
prescription. After patient encounter with Dr. Sun at the Central Clinic; Dr. Sun ordered
the prescription to Lakeview Pharmacy; where the pharmacy saw the prescription and
flagged it and sent a message to Central Clinic.

Submit your work

Document your answers directly on this activity document as you complete the activity. When
you are finished, save this activity document to your device, and upload this activity document
with your answers to your Learning Management System (LMS). If you have any questions
about submitting your work to your LMS, please contact your instructor.

Learning objectives
1. Identify compliance requirements throughout the health information life cycle (3)
2. Identify standards for exchange of health information (3)
3. Examine information operability and information exchange
4. Examine data interoperability and sharing policies, structures, and methods
5. Evaluate a Continuity of Care Record (CCR)

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 References
AHIMA. (2019). What is HIE? Retrieved from AHIMA.org:
https://www.healthit.gov/topic/health-it-and-health-information-exchange-
basics/what-hie

Corepoint Health. (2016). Understanding the Continuity of Care Record. Corepoint

Health, LLC.