Putting change in information exchange

Mary Stevens, Editor

IDC Health Insights predicts the HIE landscape will shift dramatically during the next two years, and enterprise HIEs serving integrated delivery networks and health or hospital systems stand to benefit for several reasons. Topping the list: Enterprise HIEs can more easily establish a sustainable business model, and are not as crippled by organizational issues and difficulties with data governance as their statewide and regional counterparts.

Just as important, as HIE technologies become a commodity, larger and more dominant players will grow by acquiring many of the smaller companies which currently make up the majority of the market, according to the report.

The report also evaluated 14 HIE vendors—Axolotl, Browsersoft/Open HRE, Carefx, dbMotion, eClinicalWorks, InterSystems, MEDecision, Medicity, Medseek, Microsoft, Oracle, Orion Health, PatientKeeper and RelayHealth—which supply HIE applications for enterprise, regional and statewide health information organizations. It didn’t predict a single “winner” in the rapidly changing arena.

Even if a couple of these vendors (or others) end up dominating the HIE marketplace, the wide variety of underlying technologies and delivery models won’t disappear any time soon. Eighteen to 24 months from now, the struggle over standards for data exchange will likely still be with us. That doesn’t mean hospitals and other healthcare entities will stop trying to move information between disparate systems; the need to do so will be more imperative in the coming years.  

Like HIEs, EHRs also will also continue to evolve, according to a Health Affairs report, and will likely be a key to medical homes.

However, EHRs will need to evolve significantly because current commercial record systems are underdeveloped with respect to key elements of the medical home care model: telehealth, measurement of quality and efficiency, care transitions, personal health records and registries, team care and clinical decision support for chronic diseases. Registry functions must be dramatically improved so physicians and non-physician team members can identify, track and manage patients with a large number of chronic conditions, according to the report.

Underlying all of it will be enhanced communication among providers, patients and medical home team members. Will an alert-driven module help get these conversations started? Possibly, says a recent brief by the Center for Studying Health System Change, but communication can’t be a check-off item on a patient’s record. The article suggests that policies which aim to promote electronic record adoption should consider incorporating communication skills training for clinicians.

This is a valid recommendation for every stripe of information exchange in healthcare.

 Mary Stevens, Editor
mstevens@trimedmedia.com