Health Information Exchange

Allegheny Health Network (AHN) understands that you may receive medical care from our healthcare professionals and from healthcare professionals outside of our network. Your treating providers need to have a complete and up-to-date picture of your health to provide quality medical care, particularly during emergencies. Additionally, providing current and accurate information to your health plan is essential for quality improvement and care coordination. Accordingly, AHN may participate in Health Information Exchange (HIE) and other automated data exchange to facilitate the sharing of information between your treating providers and your health plan.

AHN uses an electronic medical record to monitor your care at its physician offices, hospitals, and treatment centers. Allowing AHN to provide access to your electronic medical record to other healthcare professionals and your health plan through HIE participation and other automated data exchange will improve quality and care coordination. AHN is committed to protecting your privacy and confidentiality and uses secure means to share your electronic health information.

• To authorize AHN to share your electronic record with your treating providers and your health plan through HIE participation and other automated data exchange, please complete and sign this consent form and submit using the contact information provided on the form.
• To withdraw your previous consent, please complete and sign this Withdrawal form and submit using the contact information provided on the form.

Please note: these forms are limited to HIE participation and other automated data exchange. If you want to request copies of your medical records, please visit the Medical Records link for further information.