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Joint Health Information Exchange

The joint Health Information Exchange Initiative (joint HIE) securely connects health and benefit information systems from the Department of Defense (DOD), Department of Veterans Affairs (VA) and other federal and private sector partners.

What is Joint HIE?

The joint HIE is a secure network that shares health information. For decades, the Military Health System has operated its own HIE that has shared our health information electronically between providers at military treatment facilities, VA facilities, and other federal and private sector partners. With the joint HIE, all health providers—whether at an MTF or from the TRICARE network—can securely access beneficiary records and health information electronically.

By sharing health data through the eHealth Exchange, CommonWell Health Alliance, and Carequality, health care providers have a more complete view of a patient's health record. This can help the health care team make the best decisions.

Joint HIE Privacy and Security

The joint HIE allows MHS providers to securely access and share a patient's health information with authorized health partners. The joint HIE fully complies with the most rigorous privacy and security standards.

HIE Benefits Through Joint HIE

Access to a patient's medical history is very important to health care providers. By using the eHealth Exchange, CommonWell Health Alliance, and Carequality, DOD health care providers can have a more complete view of a patient's health record. This allows each patient and their health care team to make informed decisions for their health.

Through the eHealth Exchange, CommonWell Health Alliance, and Carequality, your health care providers can share information, such as:

  • Prescriptions
  • Allergies
  • Illnesses
  • Lab and radiology results
  • Immunizations
  • Past medical procedures
  • Clinical notes

* To improve your care experience, health information may be shared as permitted by the Health Insurance Portability and Accountability Act (HIPAA) with other authorized organizations who partner with the MHS. To enhance coordination among care teams, this includes notes written by your clinicians, which could contain information about sexual assault, domestic violence, child/elder abuse, substance abuse, mental health, and sexually transmitted diseases.

Joint HIE and COVID-19

As providers scramble to provide treatment to United States' COVID-19 caseload, joint HIE provides an essential service medical professions depend upon. Joint HIE, and their partner HIEs, ensure that providers have access to a patient's complete medical record helping them identify pre-existing conditions, past treatments and other crucial information that help them make wise treatment decisions. This information is crucial in the fight against the pandemic and can help save lives.

Joint HIE Opt Out

The joint HIE benefit is available to all TRICARE beneficiaries. All beneficiaries except active duty service members may choose to opt out of the joint HIE.

  • TRICARE eligibility and status will not change if a patient chooses not to participate.
  • If a patient chooses to opt out of the joint HIE, the MHS may not be allowed to electronically share that patient's health care information through the eHealth Exchange and CommonWell Health Alliance, not even in cases of emergency.
  • Civilian health care providers who participate in the eHealth Exchange and CommonWell Health Alliance may also require patients to complete an opt out or opt in request.

Choosing not to participate won't affect HIPAA-authorized DOD exchange of healthcare information, or the sharing of paper records with the VA. Learn More about how to opt out of the joint HIE.

Frequently Asked Questions

Launched in April 2020 by the Federal Electronic Health Record Modernization (FEHRM) office, the joint health information exchange (Joint HIE) builds upon the success of the Department of Defense (DoD) and Department of Veterans Affairs (VA) HIE work.

Q1:

What is the joint health information exchange?

A:

The joint HIE is a secure gateway used to connect to participating provider organizations across the United States who agree to securely share clinical information with the DOD; VA; Department of Homeland Security’s U.S. Coast Guard (USCG); and the Depart of Commerce, National Oceanic and Atmospheric Administration’s NOAA Corps providers. Participating provider organizations include single-physician offices to multi-hospital systems outside the federal health care systems (DOD, VA, USCG and NOAA Corps) that participate in the joint HIE.

The joint HIE enhances the ability of DOD, VA, USCG and NOAA Corps providers to access patient electronic health information quickly and securely from participating provider organizations and vice versa. Participating provider organizations now have a single point of entry to request and access DOD, VA, USCG and NOAA Corps patient information to support the continuity of care for Service members, Veterans, and other beneficiaries.

The launch of the joint HIE is a critical step forward in significantly expanding DOD, VA, USCG and NOAA Corp partnerships and interoperable capabilities. The FEHRM continues to optimize and expand the joint HIE.

Q2:

What information is shared through the joint health information exchange?

A:

The information shared through the joint health information exchange includes prescriptions, allergies, illnesses, lab and radiology results, immunizations, past medical procedures and clinical notes.

Q3:

What are the benefits of the joint health information exchange?

A:

COVID-19 showed us how important efficient electronic health information sharing is for clinicians on the front lines. The more information they have about their patients, the better they can meet their needs.

The FEHRM, DOD and VA launched the joint health information exchange (HIE) in the middle of the pandemic. During this critical time, the joint HIE is enhancing the ability of DOD, VA and USCG providers to share patient electronic health information quickly and securely with participating provider organizations.

It’s magical when a patient shows up at a health care system and that system already knows about the patient and what happened in a different health care system. This is the experience the Departments are building toward.

With 60% of DOD beneficiaries accessing care outside the federal health care systems, and 30% of VA beneficiaries doing so, DOD and VA have a lot of intersection with outside provider organizations and need to be able to efficiently exchange data.

By combining DOD and VA’s individual HIEs into a single joint HIE, the FEHRM significantly expanded the data available to all clinicians.

This means providers have access to even more information about their patients to make the best care decisions. Learn more about the benefits of the joint HIE to providers and to patients.

Q4:

How significant is joint HIE?

A:

The joint HIE allows DOD, VA, USCG and NOAA Corps providers to see health care information on their patients from any of the 268 participating provider organizations representing more than 2,000 hospitals, 33,000 clinics, 1,100 laboratories, 8,800 pharmacies and 300 nursing homes throughout the country. Participating provider organizations will only need to query a single HIE gateway to have secure access and retrieve consolidated records from DOD, VA, USCG and NOAA Corps to support the continuity of care of Veterans, DOD active-duty service members and beneficiaries.

Q5:

Why is the joint HIE necessary and important?

A:

The joint HIE makes patient information from participating provider organizations available to DOD, VA, USCG and NOAA Corps clinicians. Participating provider organizations can access records for clinical decision-making on their service members, Veterans and beneficiaries. Sharing a patient’s health information enables more informed decision-making for patient care.

Q6:

Where will the joint HIE be available?

A:

Provider organizations must participate in eHealth Exchange or CommonWell Health Alliance networks to access joint HIE data.

Q7:

Who does the joint HIE benefit?

A:

The joint HIE directly benefits DOD, VA, USCG and NOAA Corps and participating provider organizations alike by enhancing access to patient health information. The joint HIE also benefits the patient by reducing the burden on the patient to share health data in other ways (e.g., fax, mail). In turn, participating provider organizations need to query only a single HIE gateway to retrieve records from DOD, VA, USCG and NOAA Corps. This exchange supports the continuity of care for Veterans, service members and beneficiaries.

Q8:

How does the joint HIE facilitate health information exchange?

A:

The joint HIE is a secure gateway used to connect DOD, VA, USCG and NOAA Corps with participating provider organizations across the United States who agree to securely share clinical information with DOD, VA, USCG and NOAA Corps. Rather than sharing via fax, mail, or other multi-step processes, the joint HIE enhances the ability of participating provider organizations to securely access health information digitally.

Q9:

Is the joint HIE data exchange process secure?

A:

Participating provider organizations can exchange health data with DOD, VA, USCG and NOAA Corps only if they sign eHealth Exchange’s Data Use and Reciprocal Support Agreement (DURSA) or CommonWell Health Alliance’s End User License Agreement (EULA)—both comprehensive, trust agreements.

Q10:

What information is shared through the joint HIE?

A:

Through the joint HIE, providers may access information on a patient's:

  • Prescriptions
  • Allergies
  • Illnesses
  • Lab and radiology results
  • Immunizations
  • Past medical procedures 
  • Clinical notes
Q11:

What is the eHealth Exchange? What is the CommonWell Health Alliance?

A:

The eHealth Exchange is a growing health information exchange network for securely sharing clinical information over the Internet nationwide. It spans all 50 states and is one of the largest health information exchange infrastructures in the U.S. Current eHealth Exchange participants include large provider networks, hospitals, pharmacies, regional health information exchanges and many federal agencies, representing 75% of all U.S. hospitals, 70,000 medical groups, 8,300 pharmacies, 5,200 dialysis centers and 120 million patients.

CommonWell Health Alliance has a diverse mix of members and service providers who have come together to securely share health data. CommonWell Health Alliance allows organizations to find, select, match, and access patient clinical data at a nationwide scale. CommonWell Health Alliance has more than 29k connections across the United States.

Q12:

How is the eHealth Exchange and CommonWell Health Alliance related to the joint HIE?

A:

The eHealth Exchange and CommonWell Health Alliance participate in the joint HIE. These networks are composed of more than 100,000 members ranging from single-physician offices to multi-hospital systems. Participating provider organizations who are a member of either eHealth Exchange or CommonWell Health Alliance have the ability to retrieve DOD, VA and/or USCG records via the joint HIE.

Q13:

Does the joint HIE share information that might be considered sensitive?

A:

To improve your care experience, any or all of your health information may be shared, as permitted by the Health Insurance Portability and Accountability Act (HIPAA). To enhance coordination among care teams, this includes notes written by your clinicians, which could contain information about sexual assault, domestic violence, child/elder abuse, substance abuse, mental health, and sexually transmitted diseases. If you do not want to share this information, you need to opt out of the joint HIE.

Q14:

Whose information is shared?

A:

This benefit is automatically available to all Veterans, service members, beneficiaries, and other patients of participating provider organizations who choose not to opt out.

Q15:

Who can see my information?

A:

DOD, VA, USCG and NOAA Corps clinicians as well as participating provider organizations who participate in the joint HIE can see your information. A list of eHealth Exchange and CommonWell Health Alliance provider organizations can be found at Health.mil or VA.gov Through the joint HIE, DOD, VA and USCG providers have increased access to participating provider organizations. The number of participating provider organizations is growing each month, so keep checking back if you do not see your provider organization listed at this time.

Q16:

How safe and secure is the sharing of my information?

A:

The joint HIE fully complies with the most rigorous privacy and security standards. Participating provider organizations who exchange health data with DOD, VA, USCG and NOAA Corps signed the Data Use and Reciprocal Support Agreement (DURSA) or CommonWell Health Alliance’s End User License Agreement (EULA)—both comprehensive, trust agreements—before exchanging data with the joint HIE.

Q17:

How can I participate in the joint HIE?

A:

This service is part of your healthcare benefit. You are automatically enrolled. So, if you wish to participate no other action is necessary.

Q18:

Do I have to participate in joint HIE?

A:

For readiness purposes, active duty service members must participate in the health information exchange process. All other beneficiaries may choose to opt out of this benefit if they prefer.

Q19:

How do I opt out of the sharing my data with participating provider organizations?

A:

If you are considering opting out, please visit your primary care provider to discuss the benefits of participating in the joint health information exchange. Please be aware that you will need to opt out on both sides of the exchange process (i.e., federal and participating provider organization).

DOD Beneficiaries

If you would like to opt out, select, complete, and print the joint HIE Opt-Out Letter Template from the TRICARE.mil website. Then, sign and mail the letter via the United States Postal Service to the address provided on the form. Since participating provider organizations have varied rules, beneficiaries or Veterans will need to contact their providers to learn how to opt out of the joint health information exchange. If you choose to opt out, you may choose to opt back in at any time.

Veterans

If you would like to opt out, complete and submit VA Form 10-10164 to your facility’s Release of Information Office (ROI). You may also submit this form online via My HealtheVet.

Since participating provider organizations have varied rules, beneficiaries or Veterans will need to contact their providers to learn how to opt out of the joint health information exchange. If you choose to opt out, you may choose to opt back in at any time.

Q20:

What if I change my mind?

A:

If you choose to opt out and then change your mind, you can request to opt back in at any time. Most people benefit from sharing their medical information with healthcare providers, especially in the case of emergencies in which you or your loved one is not physically able to share your necessary information. Veterans may opt back in at any time before or after automatic sharing begins.

DOD Beneficiaries 

DOD beneficiaries who opt out and then change their minds can request to opt back in at any time. Simply download and complete the joint HIE Opt-Back-In Letter Template, then print, sign and mail it to the address provided on the document.

Veterans

Veterans who decide they would like to be opted back into the sharing of their health information will need to complete and submit VA Form 10-10163 to their facility’s Release of Information office (ROI).They may also opt in via My HealtheVet.

Q21:

Does my participating provider organization have the same opt out process?

A:

Participating provider organizations have varied rules regarding health information exchange program participation, as guided by state law. Please contact your provider to learn how to opt in or out of their health information exchange process.

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Last Updated: September 08, 2023
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