AHIMA: Are state-level HIEs DOA?

Are state level health information exchanges already obsolete before sprinting out of the gates? Chris Dimick, writer at AHIMA, poses the question in an article published in Journal of the American Health Information Management Association.

According to Dimick, progress has been slow since the State Health Information Exchange Cooperative Agreement Program funneled $548 million to 56 states, territories and state-designated entity HIE startups in 2010. “Many of the HIEs are still developing their sustainability plans and preparing to launch, relying solely on the government grants that run out in just a few short years,” he wrote.

Yet, a confluence of forces is driving providers to seek ways to exchange health information now. Instead of waiting for state HIEs to develop, some larger health systems have begun contracting with IT vendors to develop their own systems, focused on exchanging information among its own facilities and select outside partners, Dimick wrote.

“So many 'private HIEs' are popping up, industry analysts have begun to debate whether nonprofit regional and state HIEs have become obsolete before even taking root,” Dimick added. “Others warn that private HIEs—which may narrow their services according to margin and competitive advantage—will drain customers and resources necessary for the success of state HIEs, which aim to provide broader services and are intended to serve the greater good.”

Driven by HIE-infused initiatives like meaningful use, accountable care organizations and the restructuring of provider payment models, healthcare systems and small providers are increasingly interested in linking to an HIE, he wrote, noting a 2011 CapSite survey of 340 hospitals found that 74 percent plan to purchase new HIE tools in the near future; doubled from 2009's results.

“State HIE sustainability is the biggest question mark when it comes to long-term viability, and some in the industry foresee private HIEs lessening their chances of survival,” Dimick wrote. “If private HIEs corner the market on the most profitable services, state HIEs—charged with providing a wider scope of services with a lower return on investment, such as connecting rural providers—are being set up to fail.”

Whether private and state HIEs compete or coexist will become clearer with time, but for now providers can be understandably confused about which type to join, Dimick concluded.