Defining health information exchange: Scoping review of published definitions

Abstract

Objective The term health information exchange (HIE) is often used in health informatics, yet uncertainties remain about its precise meaning. This scoping review aimed to capture and analyse existing definitions in order to map variations in the use of this term and the concepts associated with it. Methods Systematic literature search to identify published definitions of HIE and related terms. Medline, Web of Science, Library Information Science and Technology Abstracts, EMBASE and CINAHL Plus were searched to identify relevant papers, and Google to identify grey literature. Searches were not limited by language or date of publication. Both explicit and equivalent conceptual definitions were included. Included definitions were summarised and thematically analysed in order to identify and map the underpinning constructs. Results Our searches revealed 603 scientific articles and 5981 website links. From these, a total of 268 unique definitions of HIE were identified and extracted: 103 from scientific databases and 165 from Google. Eleven constructs emerged from the thematic analysis. Contextual factors influenced the emphasis of the definitions and the overall framing of HIE as an organisational entity that facilitates and or as a process of sharing health information between diverse stakeholders. Conclusions HIE is a complex and evolving construct, for which multiple definitions exist. In order to encourage consensus, the authors propose this broad definition, which encompasses the key attributes of HIE described in the literature: "HIE is the electronic mobilisation of clinical and administrative information within or across organisations in a region or community and, potentially, internationally between various systems according to locally and/or nationally recognised standards while maintaining the authenticity and accuracy of the information being exchanged, enabling stakeholders to make informed decisions to enhance healthcare quality of a patient and population. HIEs are multi-stakeholder organisations that oversee the business, operational and legal issues involved in the exchange of information.