HIE survey: Competition, sustainability, privacy top challenges

Developing a sustainable business practice and privacy concerns top the list of priorities for health information exchanges (HIEs) this year, according to the results of the eHealth Initiative’s 2012 HIE Survey.

Of the 127 respondents, 81 named privacy as a top concern, 76 said developing a sustainable business model, 71 said lack of funding, 67 said stakeholder concerns about their competitive position in the marketplace, 67 said addressing technical barriers and 65 said addressing government policy and mandates.

When asked about competition, 36 reported that competition from other HIEs may be an important challenge, followed by 50 who mentioned competition from health IT vendors offering exchange solutions and 67 who reported stakeholder concerns about their competitive position in the marketplace.

The majority (81) of the respondents offer Direct messaging or plan to offer Direct, compared with just 25 HIEs that offered Direct in 2011.  

Forty percent of respondents are supporting either accountable care organizations (ACOs) or patient-centered medical homes (PCMHs). More than 25 percent of respondents plan to support these initiatives in the future.

HIEs indicated that they believe their initiative will be operational (90) and financially sustainable (79) after the State HIE Cooperative Agreement program ends. Of the 79 financially sustainable HIEs, 34 reported their primary source of funding is federal dollars, while the remaining 45 primarily employ other revenue models. Of HIEs receiving federal funds as their primary source of revenue, 30 reported that they expect to earn sufficient revenue from participating entities to cover all of their operating expenses, and 26 expect to be financially sustainable.

When asked about the HITECH Act’s role in achieving sustainability, 57 HIEs reported that the legislation made it easier while five thought it made it more difficult.