Key findings on the progress of the current 255 Health Information Exchanges were announced at the National Forum on Health Information Exchanges convened by the eHealth Initiative July 14th in Washington D.C. The eHealth Initiative’s survey “2011 Report on Health Information Exchange: The Changing Landscape” demonstrates a net growth of 9 percent in the number of initiatives in 2011. This shows that an unprecedented amount of patient health information is being exchanged between physician offices, laboratories, and hospitals across the nation.
The National Survey shows that there are still a number of challenges for HIEs to meet head on. Issues dealing with business models and value, privacy controls, concerns with systems integration, and participation in the uncertain future of accountable care organizations are some of the issues.
“Some exchanges have solved their technical issues and are offering more advanced services such as analytics, quality reporting, wellness programs, and education to providers and hospitals. As a result, they are in a much stronger position than those that have not expanded services,” said Jennifer Covich Bordenick, eHi’s Chief Executive Officer. “The HIE initiatives that cannot adapt quickly may not last long in a transformed healthcare system.”
According to the survey, maintaining sustainability is a critical issue. HIEs depend on federal funding and this plays a part in trying to reach a sustainable business model. The majority of HIE initiatives totaling 115 reported that they were not dependent on federal funding in the last fiscal year but 65 respondents did indicate that they were dependent on federal funding. The survey did identify 24 sustainable initiatives in 2011 that were not dependent on federal funding in the last fiscal year.
The survey points out that HIE initiatives can obtain sustainability if they are able to provide services that customers really want and offer these services faster, cheaper, and more reliably than their competitors. The “meaningful use” program helps to provide information on what services will be in demand over the next five years. eHi recommends that HIEs move quickly to help providers with “meaningful use,” Medicare Shared Savings Program rules, and privacy recommendations.
Some HIE initiatives may be positioned to act as an intermediary between disparate systems and support ACOs. Forty eight initiatives indicated that they will participate with ACOs and 38 indicated that they would not participate but the majority of HIE initiatives, 110 are simply unsure of whether they will or will not participate.
A majority of initiatives totaling 113 have plans to incorporate the federal Nationwide Health Information Networks (NWHIN) Direct Project into their services offerings. In 2010, the Direct Project initiative was launched by the Office of the National Coordinator. The goal of the Direct Project is to use of the internet as an easy-to-use secure method to replace mail and fax transmissions between providers and other providers, laboratories, public health departments, and patients. The Direct Project is currently in a pilot phase, but HIE initiatives are planning to incorporate Direct Project into their service offerings.
In her opening at eHI’s National Forum, CEO Covich Bordenick reported “eHI will be publishing new documents this August. One report will focus on markets, vendors, and will include a list of vendors, a special report will be published on the 24 organizations able to maintain sustainability, and a report on all of the workforce problems dealing not only with employment issues but all the workforce gaps that exist in the healthcare system.
The “2011 Report on Health Information Exchange: the Changing Landscape” presents an overview of the exchange landscape, changing business models, patient services, enhancing patient privacy, recommendations for moving forward and much more. The full report and aggregate data sets are available for purchase at the eHI website www.ehealthinitiative.org.