Convergence: A watchword for 2011

Mary Stevens, Editor

Two of the major HIE news stories of the year were acquisitions. In August, UnitedHealth Group’s Ingenix Division bought Axolotl. Then, earlier this month, Aetna announced its acquisition of Medicity. Since these occurences, there has been a fair amount of punditry about what this might mean for the future of HIEs as we know them.

Convergence is a word that came up often. There’s a push bring together administrative information and clinical information to benefit patients, said Medicity CEO Kip Lassetter, in a CMIO interview shortly after the announcement. Until now, however, these data have existed in two alternative realities, he said, with the built-out administrative infrastructure on one side and HIE systems, with their origins in billing systems on the other.

Both companies have had an eye on accountable care organization (ACO) models of care. Medicity’s HIE infrastructure plus Aetna’s administrative capabilities could be a potential infrastructure that includes a payor component and provides a complete ACO infrastructure. There’s an opportunity to partner with provider networks for an ACO-in-a-box, Lassetter said.

Since the acquisition, there has been a flurry of Medicity HIE client news. Even if these announcements are coincidental to the acquisition, on the whole they’re probably reassuring for Medicity in that  clients may be wary of having an insurance company so close to clinical data, but that doesn’t seem to be a deal-breaker.

For its part, Aetna wouldn’t make this move if it didn’t expect a substantial return on its $500 million investment, especially if other payors were interested in Medicity.

Now, with two large HIE players off the acquisition table, there might be additional insurance-HIE mergers in the coming months, but they’re not likely to trigger the apparent market shifts that accompanied the Medicity and Axolotl buys.

Meanwhile, federal incentive work goes on. Recently, for example, the ONC announced it has allotted more than $16 million to fund the Health Information Exchange (HIE) Challenge Program, which encourages breakthroughs for nationwide HIE and focuses on five key needs:

• Achieving health goals through HIE;
• Improving long-term and post-acute care transitions;
• Giving patients access to their own health information;
• Developing tools and approaches to search for and share granular patient data (such as specific lab results for a given time period); and
• Fostering strategies for population-level analysis.

Awards will fund the development of technology and approaches that will be developed in pilot sites and then shared, reused and leveraged by other states and communities to increase nationwide interoperability.

Convergence will be a word that is bound to come up frequently in HIE conversations next year.

Mary Stevens
Editor of CMIO
mstevens@cmio.net