Assessing the relationship between health information exchanges and public health agencies.

While health information exchange (HIE) continues to be promoted by both private and public sector supporters as potentially transformative for healthcare, there is concern as to how it will relate to and assist population health activities. This article reports the results of an on-line survey of regional health information organizations (RHIOs) and state and local health department representatives' beliefs and attitudes regarding collaboration in HIE. Factors that may encourage cooperation among public health agencies and RHIOs include broader geographic and multiorganization catchment areas, early laboratory involvement, early inclusion of public health as a RHIO partner, and efforts to resolve perceived barriers to cooperation. The exchange of electronic lab data was the most common type of data being exchanged and could serve as a model for how to accomplish HIE in general. Health departments (state and local) may serve as neutral conveners of RHIOs and could offer a bridge for acceptance by stakeholders, dispelling mistrust, offering data management expertise, and a capacity and tradition of ensuring privacy for confidential data.