HIE activity snowballs

Beth Walsh, Editor, CMIO

From Maine rolling out a medical imaging archive to Ohio implementing an emergency department alert system to a study showing that the use of health information exchange (HIE) can curb unnecessary head CTs, HIE activity is chugging along at a brisk pace. In fact, the HIE market will experience massive growth in spending by 2014 even though industry technology executives are exploring adoption rather than implementation at this point, according to a new survey from Black Book Rankings.

The survey of 4,000 healthcare and insurance organization executives found that the majority of U.S. hospitals (80 percent) and physicians (97 percent) have yet to implement an HIE system. The report also found that 28 percent of respondents are cautiously increasing HIE spending before the end of 2012, but eight of 10 providers expect organizational HIE budgets to significantly increase by 2014.

Ninety-five percent of all providers expect to be included in at least one HIE interface by July 2013 and almost all providers (98 percent) with HIE strategies in place will focus entirely on community or regional exchanges for the foreseeable future, rather than national health record exchange initiatives.

Meanwhile, states enacted more than 300 pieces of health IT legislation from 2000 to 2011, according to a report from the Healthcare Information & Management Systems Society (HIMSS) State Advisory Roundtable.

The success and sustainability of HIEs are a common challenge for states. “Stage 2 meaningful use will drive much more rapid development but that is no guarantee of success of state-run HIEs,” the report noted. “There has always been a concern about state-run HIEs being able to compete with private options that are emerging as the market organizes.”

The report included recommendations such as states continuing to leverage their state-level HIE and state-level health IT infrastructure in new and innovative ways, keeping health IT on the federal and state agendas over the next several years in order to continue the current momentum and improvement of care quality and healthcare spending and state-level HIEs preparing to shift their business models as federal and state health reform policies continue to shift from fee-for-service to pay-for-quality models to maintain sustainability.

A panel discussion at the Healthcare IT Connect Summit resulted in an overriding consensus among participants of the need to build a use case for HIEs.

Are HIEs positioned to add value and provide timely support to patient-centered medical homes and accountable care organizations (ACOs)? asked Lynn Dierker, senior program director, National Academy for State Health Policy.

John Kansky, vice president of product management at the Indiana Health Information Exchange, noted that patients attributed to ACOs will receive 30 to 45 percent of their care outside of the ACO system. That raises the question of how to entice health plans, providers and payors to foot the bill to share clinical data--data generally hoarded for leveraging purposes.


“[HIE] must have a business case,” said Dave Goetz, vice president, state government solutions, Optum. If an HIE must present a business case, how can an organization build value among its targeted community?

One piece of advice Jeffrey Milller, CEO, North Carolina HIE, mentioned was to start with basic functions before trying to advance services. “You don’t want to swim with sharks if you can’t [swim] freestyle,” Miller commented. Jan Lee, executive director, Delaware Health Information Network (DHIN), echoed this sentiment by stating a key principle to drive adoption and utilization at DHIN was doing core services “very well” before expanding service lines.

Will the next month bring another flurry of HIE activity? We will report on the latest in July.

Beth Walsh
CMIO Editor
bwalsh@trimedmedia.com