eHI: Sustainable HIEs up 33% from 2010
Very few health information exchanges (HIEs) become sustainable in one year, according to Jason Goldwater, VP of research and programs at eHealth Initiative (eHI). Speaking at a webinar hosted by the Washington, D.C.-based organization, Goldwater shared some key findings from its latest report, “2011 Report on Health Information Exchange: Sustainable HIE in a Changing Landscape.”
Sustainability is challenging because it’s difficult to calculate a clear, measurable ROI for providers, making them less inclined to participate and share clinical data, Goldwater said during the Nov. 10 session. He added that only seven HIEs out of the 196 respondents of 255 known HIEs in the country became sustainable in one year.
Out of the 196 respondents in the 2011 survey, 24 (12 percent) reported being self-sustaining, a 33 percent increase over 2010 where 18 sustainable HIEs were identified. “Only half of the 24 sustainable initiatives indicated it took them three years or less to be sustainable,” the report stated.
According to the report, sustainable HIEs are slightly more likely to have a hybrid architecture model, utilizing both centralized and federated components as well as some centralized health data.
The use of membership fees is the most common revenue model among sustainable HIEs, Goldwater added, noting that the most exchanged data are lab results, care summaries, emergency episodes and medications.
Developing a long-term business model for future growth and sustainability proves to be the most difficult challenge for HIEs, the report noted. For those HIEs that were classified as sustainable, they continued to deal with issues common among a majority of HIE initiatives, such as organizational and governance issues; privacy and confidentiality issues with the exchange of personal health information; and technical issues, such as architecture, applications and connectivity.
Stakeholder involvement varies across the sustainable initiatives, but hospitals, primary care physicians and specialty physicians were primary stakeholders as both data providers and receivers for each of the 24 HIEs that were classified as sustainable, both from a governance and data exchange perspective. This likely reflects the expanded role associated with advanced HIE development and the capacity of these initiatives to offer services beyond simple data sharing among providers, the report asserted.
According to the report, five commonalities among sustainable efforts were identified, including:
The report is available from eHI's website.
Sustainability is challenging because it’s difficult to calculate a clear, measurable ROI for providers, making them less inclined to participate and share clinical data, Goldwater said during the Nov. 10 session. He added that only seven HIEs out of the 196 respondents of 255 known HIEs in the country became sustainable in one year.
Out of the 196 respondents in the 2011 survey, 24 (12 percent) reported being self-sustaining, a 33 percent increase over 2010 where 18 sustainable HIEs were identified. “Only half of the 24 sustainable initiatives indicated it took them three years or less to be sustainable,” the report stated.
According to the report, sustainable HIEs are slightly more likely to have a hybrid architecture model, utilizing both centralized and federated components as well as some centralized health data.
The use of membership fees is the most common revenue model among sustainable HIEs, Goldwater added, noting that the most exchanged data are lab results, care summaries, emergency episodes and medications.
Developing a long-term business model for future growth and sustainability proves to be the most difficult challenge for HIEs, the report noted. For those HIEs that were classified as sustainable, they continued to deal with issues common among a majority of HIE initiatives, such as organizational and governance issues; privacy and confidentiality issues with the exchange of personal health information; and technical issues, such as architecture, applications and connectivity.
Stakeholder involvement varies across the sustainable initiatives, but hospitals, primary care physicians and specialty physicians were primary stakeholders as both data providers and receivers for each of the 24 HIEs that were classified as sustainable, both from a governance and data exchange perspective. This likely reflects the expanded role associated with advanced HIE development and the capacity of these initiatives to offer services beyond simple data sharing among providers, the report asserted.
According to the report, five commonalities among sustainable efforts were identified, including:
- Robust and mature initiatives: Sustainable HIEs are more likely to be in existence for between six and 13 years.
- Nonprofit organizations: Acting as a neutral third party with the ability to convene competing organizations to participate in the HIE in some capacity.
- Fully functioning: Generally, sustainable HIEs were started in response to a community need—either clinical or administrative.
- Providing diverse service offerings and data: This assists physicians and hospitals to help them achieve meaningful use and improve workflow processes to realize greater efficiency and manage costs.
- Making participation affordable: By keeping operating costs as low as possible, leveraging resources and expanding revenue streams to achieve economies of scale the organizations were able to pass the savings onto their customers.
The report is available from eHI's website.