Experts: Successful HIEs require time, early support

Slow and steady may be the best approach to launching sustainable and effective health information exchanges (HIEs), according to speakers at National eHealth Collaborative’s May 29 webinar.

Yvonne Hughes, executive director of Coastal Connect HIE in southeastern North Carolina and Dan Porreca, executive director, HEALTHeLINK in western New York shared this morsel of wisdom among other advice during the event.

“The cornerstone of our success was our governance structure,” said Hughes, explaining that governance activities took place a full two years before any technology was deployed to build the HIE. The governance body featured regional hospitals, a regional extension center, rural and urban physicians and community care organizations.

Together they established their purpose and principles that helped cement their commitment to the Coastal Connect HIE project. In their case, they strove for an HIE that is patient centric and offers value to providers with the goal of delivering longitudinal health records and facilitating the export and sharing of datasets.

Likewise, HEALTHeLINK in New York evolved over a period of time. Porreca explained that the HIE was a continuation of more than 12 years of collaborative efforts by the region’s four major hospitals and three health plans. In 2001, they developed an administrative data exchange, and in 2005 they conducted a feasibility study for the exchange of clinical data. These early efforts informed HEALTHeLINK’s launch in 2008.

“The need for collaboration is a critical success point,” he said, stressing the importance of “getting competitors to sit at the same table and have a conversation on where it makes sense to collaborate and where it make sense to compete.”

In terms of infrastructure, he said connecting hospital systems, healthcare organizations and physician practices required significant local, state and federal investment. To that end, “things took time,” he said.

For Coastal Connect HIE, Hughes said they achieved success in large part because sustainability and pricing issues were addressed up front with participating entities.

“If everyone understands what the costs will be, including resources, staff, technology and legal fees, they go in with their eyes wide open,” Hughes said, adding that the HIE now utilizes a “pay to play” subscription model that focus on affordability to drive sustainability. She said they keep fees as low as possible because the greater number of engaged users, the richer the data.

Coastal Connect HIE is witnessing much growth: currently it encompasses 210 physician practices and 750 providers including five hospitals.

Likewise, Porreca reported that HEALTHeLINK is seeing continued growth. He said almost all area hospitals and major radiology practices in western New York are participating in the HIE, which now encompasses more than 90 million total clinical records with 1.9 million added every month.

Patient record look-up queries are increasingly popular, he said. So far, the HIE has facilitated 324,000 patient queries and this number grows each month.

Porreca emphasized the importance of working with providers to incorporate HIE usage within their workflow to enhance the services they can provide to their patients. He said now the HIE is working to incorporate its functionary directly into the EMR.

On the patient side, he said disseminating consent forms to allow individuals to opt in or out of the HIE is essential. At HEALTHeLINK, nearly 500,000 individuals have consented. He added that more than 50 percent of the population over 60 has agreed to include their health information in the system. “It is starting to reach critical mass,” he said.

In advice to others aspiring to launch HIEs, Porreca encouraged them to “find strong committed leaders in the community that can help shepherd this. Nothing goes as quickly as you would like. If you make continual progress, you can look back and say, “Yes, we’ve achieved some things.”