State Wide Health Information Exchange System Delivers Significant Benefits for Healthcare Sites In North Carolina

Rationale / Objectives

  • North Carolina is one of the most rural states in the US, where the need for access to patient health records is vital to provide high quality care and health outcomes for patients.

    Project/Program Description & Major Achievements

    • North Carolina’s governments designated North Carolina Health Information Exchange (NC HIE) as the statewide health information exchange following the development of a strategic statewide HIE planned by a broad pool of healthcare stakeholders within the state. The system provides a secure site for multiple healthcare practices to exchange patients’ data, especially in rural communities. In 2015, there were 920 participating sites across the state serving approximately 1.482 million unique patients.

    Lessons Learned

    • It was challenging for NC HIE to demonstrate the value of the system to healthcare sites before they adopt it. Despite the significant benefit of the HIE system, it took time and effort for these sites to adopt and integrate the new system with their Exchange Health Records systems.

    Further Description

    North Carolina Health Information Exchange – NC HIE (recently changed to North Carolina Health Information Exchange Authority) operates North Carolina’s statewide health information exchange. The system is powered by Orion Health Collaborative Care, a comprehensive care management solution. This is a secure, standardized electronic system in which providers can share important patient health information. The NC HIE enables participating healthcare providers to:

    • Eliminate paperwork and reduce time
    • Dedicate more informed treatment decision-making
    • Potentially improve in-care coordination, quality of healthcare, and better health outcomes[2]


    NC HIE delivers an extensive, statewide health information exchange network accessible through a web-based Clinical Portal or directly from within a provider’s Exchange Health Records. Along with its service offering, NC HIE also serves as a DirectTrust – an accredited Health Information Service Provider (HISP). This is an organization that ensures the safety of patient health information during communicating between healthcare providers via the national Direct secure messaging protocol. NC DIRECT allows messages to be exchanged securely between any NC HIE authorized users, as well as other users of Direct secure messaging nationwide [3]. The NC HIE network began to implement in 2012. To date, there are more than 920 participating healthcare sites “including hospitals, physician practices, specialty care practices, health departments, home health agencies and long-term care organizations”, which are able to securely share patient health records [3]. Plus, NC HIE has partnered with the state to connect approximately 1,500 ambulatory practices within a three-year period that began in 2013 [4] According to NC HIE’s president, Chris Scarboro, getting ambulatory care organizations connected with different healthcare entities were greatly beneficial. Being a mostly rural state, ER (Emergency Room) in rural communities had needs in accessing to patient’s data, where they can benefit a lot from NC HIE and NC Direct [4].