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The million dollar HIE question

March 25, 2010
by kate
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As anyone who attended the 2010 HIMSS Conference can attest, healthcare information exchanges (HIEs) are a hot topic. They were the subject of several educational sessions and panels, not to mention my meetings with vendor reps.

But it still seems to me that while the idea of sharing data among organizations is strongly supported, as it can go a long way in improving patient care, there is still quite a healthy dose of skepticism as to how HIEs are going to pan out. In December, I spoke with a CIO has not been impressed with the efforts so far to launch statewide data sharing in his neck of the woods.

That begs the question — what is it exactly that is causing concern among CIOs and other hospital leaders? With that in mind, HCI posted the following poll question a few weeks ago, and received these rather interesting results:

Statewide health information exchange programs were a hot topic at HIMSS10. What concerns you most about HIEs?

· Interoperability among disparate systems 26.1%

· Unwillingness to share data 30.4%

· Insufficient funding 17.4%

· Too much government involvement 17.4%

· None of the above 8.7%

The question struck a chord, receiving more responses that any other poll question had in six months (and that was because we asked readers which vendor compares most to the New York Yankees). A few readers were even motivated to leave thoughtful comments:

· Comment 1: We, here in Indiana use our HIE (Indiana Health Information Exchange) a lot and love it, but it does have its drawbacks. The biggest is that only the largest hospital systems in the Central Indiana area are sending data to IHIE. The large hospital systems outside of Central Indiana, almost all of the medium hospitals, and all of the small hospitals are not participating. The reason they give is the cost for developing an interface with IHIE. IHIE has received a grant from the stimulus package, but it isn't enough to cover the hospitals and large physician groups across the state. Therefore, they will probably go after the large hospital systems outside of central Indiana and the medium sized hospitals in central Indiana with this grant money. Since we are a large physician organization that covers a large portion of the state of Indiana, only those practices in central Indiana are going to benefit from this push, which are also the ones who are currently benefiting from the data they are currently receiving.

· Comment 2: How do we incorporate mental health information? Privacy laws are even more stringent for that information.

I think we’ve hit on something extremely important here. And as HCI continues to increase our coverage of policy issues — and HIEs in particular — we’d love to hear your thoughts.

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Comments

* Managing consumer consent for sharing PHI (protected health information) is another policy issue that needs resolution since there is no consistency of approach across states.

* Who are the real beneficiaries of HIE? - payers? employers? providers? If a provider is reimbursed on number of procedures, and use of HIE reduces that number, what incentive does a provider have to take exchange data via HIE? A sound policy on reimbursement would be needed to encourage participation from constituents.

kate

Kate Huvane, Associate Editor of...