Health information exchange (HIE) is the electronic sharing of health information among authorized people and organizations. For nurses, its practical value is access to information that may not have originated in the local EHR, such as an outside discharge summary or recent test result.
Receiving information is the beginning of a clinical review. It does not establish that the information is complete, current, or already reconciled with the patient's present situation.
Two ways information can arrive
ONC describes directed exchange as sending information to another care professional and query-based exchange as finding or requesting information from other providers. A discharge summary sent to a known receiving team is an example of the first. Searching participating sources during an unplanned visit is an example of the second.
The available information depends on the exchange and participating organizations. A missing result in an exchange should not be interpreted as proof that the test was never performed. Similarly, an outside medication list is evidence about a prior record, not an automatically verified list of what the patient is taking now.
Make the source and date visible
A useful nursing review identifies who produced the information, which patient and encounter it concerns, and when it was recorded. Determine whether an item is an original observation, a summary, or a later copy. Preserve uncertainty when the source cannot be established.
Patient matching is part of this process. The SAFER patient-identification guide emphasizes accurate demographic information and reliable matching. Similar names and plausible histories are not enough to resolve an identity concern.
Illustrative transfer review
An illustrative transfer packet contains two medication lists with different dates. The older list appears first in the viewer; the newer discharge summary includes a change. The receiving nurse uses the approved reconciliation process to clarify the current plan rather than accepting whichever list is easiest to open.
The example illustrates the difference between making records available and establishing their current clinical meaning. It does not assign prescribing authority or replace a facility's medication-reconciliation policy.
Fit exchange into handoffs
Decide who reviews outside information and how important discrepancies reach the responsible clinician. A successful electronic delivery does not prove that anyone has read the document or acted on an unresolved issue. The SAFER clinician-communication guide recommends reliable information exchange during transitions and monitoring of communication patterns.
Use only authorized access for the care or work purpose allowed by the organization. The technical ability to search for a person does not itself establish permission to do so. Specific consent, privacy, and disclosure rules depend on the information and applicable requirements.
A local HIE evaluation should ask whether nurses can find relevant information, identify its source, and incorporate it into the care workflow. Counting connections or downloaded documents alone does not answer those questions.
Sending a record successfully and using its information correctly are separate tests of interoperability.
Related
Sources
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ONC: About Health Information Exchange (accessed 2026-09-17).
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SAFER: Patient Identification (accessed 2026-09-17).
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SAFER: Clinician Communication (accessed 2026-09-17).