Trust and money: Integral for HIE success
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| Mary Stevens, Editor |
Successful HIEs require competing hospitals to trust each other enough to exchange patient data. They require all interested entities to trust the technology to work, and invest accordingly. They must also trust that there is a value—better patient care—included in the plan. That mistrust is surmountable, as this CMIO interview indicates.
The other worry that keeps many CMIOs up at night is an old familiar monster in the wiring closet—money. To build a sustainable HIE, you need to show that you have a system that reliably delivers value to the entities that wish to share data. But you can’t build such an exchange without large upfront investments in technology and time. Using open-source components can be one way to lower costs, says one implementer in Connecticut.
Today’s HIEs are coming online powered by technology with a multi-year track record. Building on early adopters’ efforts, prospective HIE customers can build data-sharing policies and procedures with fewer tears and lower attorney fees.
Among recent announcements:
- The VA and Kaiser Permanente launched a medical data exchange pilot program that enables clinicians from VA and Kaiser to obtain a view of a patient's health using EHR information through the National Health Information Network. The pilot program connects Kaiser's HealthConnect and the VA’s EHR system, VistA.
- Memorial Healthcare System, a public, non-profit healthcare provider serving South Broward County in Florida, will deploy Axolotl’s Elysium Exchange to clinically network their hospitals’ health information with disparate EMR systems in physician practices.
However, the ground continues to shift. The State of California has decided to form a new governance entity for California HIE, and the California Regional Health Information Organization (CalRHIO) is disbanding. The CalRHIO board of directors said it will be “an active partner with the state in working toward a successful conclusion for the governance of HIE services in California.”
On the national level, the Journal of the American Medical Informatics Association in the January/February issue, published research indicating that the Nationwide Health Information Network (NHIN) trial implementations project showed promise, and “proposed data specifications as the starting point for data exchange nationally were quite suitable for the goals of the project and for the eventual NHIN rollout,” said lead author Gilad J. Kuperman, MD, PhD., in an interview earlier this month.
One size will never fit all when it comes to HIE technology and there’s no single approach to building exchanges or interconnects. But there are enough examples of open source and proprietary systems working together to allow CMIOs to take heart and seek out the system that works best for them. The Integrating the Healthcare Environment (IHE) Connectathon 2010, held recently in Chicago, included more HIE vendors than previous years, and many systems achieved interoperability with others. Among them were Axolotl and Misys.
Mary Stevens, Editor
mstevens@trimedmedia.com