HIEs: A wide-open market, better systems and trust

Mary Stevens, Editor

Healthcare organizations in California, Colorado, Illinois, Montana and Texas recently announced health information exchange (HIE) initiatives, and their vendor picks indicate the market is not “consolidated” yet. The size and scope of projects also vary tremendously: One size may never fit all HIE, but clearly there are many vendor options.

The Industry Advisory Council advised the Department of Veterans Affairs (VA) to commit to a plan to move to an open source, open-standards model for the next generation of the department’s integrated health information system, VistA. In its 100-page report, the IAC provided recommendations to VA on how to modernize VistA. The objective is to provide an environment within which VA employees, large prime contractors, healthcare professions, small companies, healthcare software vendors and entrepreneurs can all contribute to improving “the best care anywhere,” said the IAC.

Improving veterans’ care was also the goal of the Improving Veterans’ Electronic Transition Services Act (iVETS Act), legislation to encourage the Department of Defense and the VA to create an internet-based portal for veterans to access their records and benefits information electronically.

Calls for improvement—in the form of comments on the ONC’s proposed EHR certification and testing processes—also made the news this month. The Electronic Healthcare Network Accreditation Commission, a non-profit standards development organization and accrediting body, outlined its recommendations. Among other things, the commission asked the ONC to allow it to be designated as an HIE certifier without being an EHR certifier.

Certification is part of the “fabric of trust” that developers and policymakers are working to build into every part of the Nationwide Health Information Network (NHIN). Trust is most vital component of electronic health information exchange, and the NHIN will achieve it via certified participants. These exchange partners must pass a standard process for participation, sign an agreement that codifies requirements for systems, exchange purposes, actions to take if “untoward events” occur and penalties for violations. A webinar presented by the National eHealth Collaborative elegantly explained the five tenets of this fabric of trust.

NHIN operations are trusted enough that a growing list of exchange partners are sending and receiving "live data,” according to the speakers.

Will a fabric of trust eventually cover all HIEs, or is this the same fabric found in the fable about the emperor's new clothes? Let me know your thoughts.

Mary Stevens, editor
mstevens@trimedmedia.com