NeHC offers HIE guidance

Creating and maintaining a successful and sustainable health information exchange (HIE) initiative is difficult but not impossible, according to an April report from the National eHealth Collaborative (NeHC).

The report, “Health Information Exchange Roadmap: The Landscape and a Path Forward,” offers stakeholders a picture of efforts being undertaken by both the public and private sectors to create and implement the building blocks for widespread deployment of interoperable HIE. It provides an understanding of how these diverse approaches fit together into a strategy for nationwide HIE and suggests a four-phase roadmap to help HIE initiatives make progress and become sustainable:

• Phase 1: HIE Objectives and Vision–A local multi-stakeholder leadership group should come together to decide why they want or need to exchange health information in their community. This leadership group should have representation from all major healthcare stakeholders in the community, including consumers, providers, employers and other key opinion leaders.
• Phase 2: Market Assessment–Market conditions and community readiness should be thoroughly assessed and understood. Under the direction of the multi-stakeholder leadership group, there should be an inventory and assessment of the capabilities and HIE infrastructures that are currently available not only at the national level (described herein) but also at the community level.
• Phase 3: Strategy Development–Based on the vision and objectives of the community and the results of the market assessment, the multi-stakeholder leadership group will next need to identify strategic options for implementing HIE, evaluate the pros and cons of those options, and develop the strategy for deployment. This strategy should include an understanding of the value proposition for each potential participant and a consensus decision on potential business models for financial sustainability.
• Phase 4: Strategy Implementation–Technical requirements, roles and responsibilities, capital and financial implications, data sources and service rollout timing will need to be identified.

The Washington, D.C.-based NeHC consulted with more than 60 experts and HIE thought leaders to provide input into the final roadmap. “The availability of national standards is a critical foundation for HIE.  With this in place, HealthBridge is able to focus on connecting our customers to better information that brings value, improves patient care and positions them for success in a changing environment,” said Keith Hepp, interim CEO, HealthBridge, Cincinnati.

A common theme heard through the expert feedback was that challenges remain and there is a need for a collaborative process to tackle remaining challenges, which include funding and sustainability, variations in how interoperability standards are implemented, provider adoption, disparate EMRs and privacy/security, the report stated.

The HIE Roadmap coincides with the launch of NeHC’s HIE Learning Network, a series of workgroups to build consensus on best practices that can bring value by addressing some of the ongoing HIE challenges. NeHC will begin this process by seeking feedback from all interested stakeholders on the most important issues to tackle.  Based on feedback to date, initial topics for these workgroups may include:

• Business models for financial sustainability
• Measures of success
• Best practices for prioritizing and phasing implementation of HIE services
• Stakeholder engagement and governance best practices
• Role and function of HIE in support of accountable care

“The ultimate goal of HIE is to ensure that the right information is available at the right time and place every time to support the delivery of high quality, well coordinated and cost effective patient-centered healthcare,” the report concluded. “Keeping a consistent and clear focus on what is best for the patient is above all else the smartest way to stay on course in the ever-changing environment of HIE.”