Statewide Health Information Exchange

Advancements in statewide health information exchange (HIE) have allowed Texas health care providers to securely exchange health information. This has increased the coordination and quality of care while improving efficiency in the health care system and increasing consumer empowerment and control.

The Texas Health and Human Services Commission’s (HHSC’s) Health Information Technology and HIE program leads the HIE Connectivity Project and HIETexas Patient Unified Lookup System for Emergencies (PULSE).

The primary objectives of the HIE Connectivity Project are to increase HIE use and adoption by Texas Medicaid providers, create additional state infrastructure to support use and adoption and bring clinical information into the HHSC Medicaid department via HIE. The HIE Connectivity Project works toward its primary objectives through the following three strategies.

Strategy 1: Medicaid Provider HIE Connectivity

This strategy helps Medicaid providers connect to local HIE organizations that contract with HHSC. Contracted local HIEs include C3HIE, Greater Houston Healthconnect and Connected Care Exchange. These connections facilitate electronic reporting and data exchange between providers and the HHSC Medicaid department.

Texas Government Code, Subchapter V, Health Information Exchange Systems, Section 531.901(4), defines a local or regional HIE. Local HIEs typically offer services within their geographic regions; however, they may also offer services in other areas of the state.

Strategy 2: HIE Infrastructure

This strategy established and maintains statewide HIE infrastructure to support connectivity with the state’s Medicaid system and assists local HIEs in connecting to HIETexas, which is a set of state-level shared services managed by the Texas Health Services Authority. This infrastructure aids in the exchange of Health Level Seven Admission, Discharge and Transfer (ADT) alerts and Consolidated Clinical Document Architecture messages.

Strategy 3: Emergency Department Encounter Notifications

This strategy may help Texas Medicaid reduce emergency department (ED) use and hospital readmissions by enabling better follow-up care through electronic transmission of ADT data from hospital EDs. ADT alerts are received by subscribers, such as Medicaid managed care organizations, dental maintenance organizations, behavioral health providers and other approved health care entities, when an in-network patient is admitted to an ED, facilitating timely care coordination.


During declared disasters, PULSE allows verified and onboarded responders to securely access patient documents from providers connected through local HIEs and national networks. PULSE provides clinical data and medication history that is vital to coordinate care for at-risk patients in alternative care settings. The system also features a tool to help find missing individuals and aid in family reunification.