April 15, 2008

"Perspective: The Future Looks Good for Health Information Exchanges"

By Patty Enrado

Providers are actively discussing participation, if they aren’t already participating, in health information exchanges (HIEs), according to Marc Holland, program director of provider research for Health Industry Insights (HII).

In his April 1st Webinar, “Connectivity for Hospitals and Communities,” Holland said that results from IDC-HII’s Leading Indicators Survey Q3 2007 are “directionally encouraging.” Fifteen percent of hospital respondents indicated that they were already participating in an HIE, while 35 percent noted that they were in active discussions. “Some form of HIE is high on the radar screens of hospital CIOs,” he said.

In a February 2008 IDC-HII straw poll of community hospitals CIOs, 22.7 percent said their healthcare system was participating in an HIE, 18.2 percent were not currently participating but expected to in less than a year and 27.3 percent were not currently participating but are evaluating HIE participation.

Thirty-three percent of community hospital CIOs are participating in a proprietary HIE, which is an HIE that is part of an IDN or closely tied to a sponsor versus an HIE that involves multi-stakeholders. Twenty-five percent stated that they expect to participate in a proprietary HIE within one year.

“The rate of progress is rapidly increasing, but it’s taking a proprietary bent,” Holland said.

With interest on the upswing, he predicted:
• Organic growth, from the bottom up
• Absent more active government participation and funding, progress will be slower than anticipated
• Complexity, privacy and confidentiality issues remain key challenges
• Proprietary HIEs will surpass community-based regional health information organizations as the dominant model for exchange

Holland noted a number of operating HIEs are successful. The common characteristics, he said, are those that were formed as a grass roots effort, driven by strong, commonly held community goals or the dominance of a single provider. “Successful models will serve as ‘EMR-lite’ offerings,” he said, which would allow providers who can’t afford an electronic medical records system to participate through technologies that enable connectivity. Holland pointed out that Axolotl’s system is such a tool, which provides secure messaging of clinical data.

There is “real value” in hospital connectivity, Holland emphasized. All hospitals have voluntary attending physicians who need access to, but do not have, both hospital and their own office information. “There is a need for incorporating information in the most convenient setting,” he said. “They need information to be convenient, consistent and readily available.” This is an important contribution of an HIE, he said.

While multiple models will emerge and co-exist for many years to come, ultimately, said Holland, HIEs are in good position to demonstrate value for all stakeholders.