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Competition in the HIE Field: Don't be the Last One Standing

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Competition from other HIEs and vendors seen as important challenge for health information exchanges

Remember back in middle school gym class when the team captains began the agonizing process of selecting teams for whatever the sport you were playing at the time. You’d cringe and hope you wouldn’t be the last kid standing waiting to be chosen for a team. Well, that seems to be a possible consideration for organizations that are still pondering their next steps for health information exchange (HIE) and community alignment.

During a Sept. 27 webinar, the nonprofit eHealth Initiative released preliminary results of its 2012 Health Information Exchange survey, with one of the key findings that competition may be impacting HIE participation. Thirty-six of the 127 organizations that completed the survey reported that competition from other HIEs was an important challenge, while 50 reported that competition from health IT vendors offering exchange solutions was a challenge. Sixty-seven organizations reported stakeholder concerns about their competitive position in the marketplace as a key obstacle.

Among the panel of HIE leaders who responded to the initial results, Trudi Matthews, director of policy and public relations of HealthBridge in Cincinnati, said that competition from vendors was a key concern in her market. “Stage 1 meaningful use really did not help health information exchange providers in that it gave them a lot of competition from EHR vendors who said, ‘look you don’t need to connect to an HIE, all you need to do is connect to us and you’ll be able to meet Stage 1, and probably Stage 2 meaningful use,’” she said. “Well, of course, that didn’t help us a great deal as exchanges.”

During another eHealth Initiative webinar, this one about HIEs relation to accountable care organization (ACO) development, John Stanley, principal, Impact Advisors, said that most of the industry was focusing on the enterprise HIE to create networks of care coordination across communities  to connect at the risk management, quality, or cost-centric level. This organization-led, rather than public-led, HIE links and empowers the hospital with physicians to ensure loyalty, create opportunities for revenue growth, and establish a ‘nucleus’ for coordinated care in the community.  

“An organization might do this to be a leader in their marketplace,” said Stanley. “People have heard the term ‘land grab,’—and I don’t want to overuse it—but certainly there is a race of some sorts to build that network, and once an organization is connected through these sorts of programs, it’s tough to change that incumbent relationship. It’s really about those established relationships.”

As I pointed out in my recent article about the rise of the chief integration officer role in healthcare IT, enterprise linkages between hospitals and their employed and/or affiliated physicians are becoming increasingly important in the multitude of initiatives organizations are undertaking to prepare for greater contractual risk for population management and value-based care initiatives. In this new era of accountable healthcare, the chief integration officer is now responsible for linking hospitals and providers in the care continuum.

So, it seems that time is of the essence for organizations to figure out next steps for health information exchange. Strategic alignments and smart partnerships need to be made so your organization will not be the last one standing.