Sustainability

As the health information exchange (HIE) concept evolves forward across the U.S. healthcare industry, leaders of different HIE organizations are pursuing divergent strategies that meet the needs of their regions. But a key, largely unresolved, issue around the sustainability of funding remains common across the sector.

HealthInfoNet, Maine’s statewide HIE, started as a feasibility study in 2004, sponsored by the public/private partnership of the Maine Center for Disease Control and Prevention (Augusta), an organization that at that time was called the Maine Health Information Center (now the Manchester-based Onpoint Health Data), and the philanthropic Maine Access Foundation (Augusta). After engaging providers, consumers, and others, the actual planning process started in 2005 with coming up with core principles on what the exchange should address and a clinical and technical group that put together the first technical specifications for the exchange. Fast forward to this June as HealthInfoNet just finished its two-year demonstration phase with the state’s six major healthcare organizations, which represents about 50 percent of Maine’s population, sharing patient information. The organization is now plowing forward to get the rest of the state on board. HealthInfoNet’s Executive Director Dev Culver, previously the CIO of Eastern Maine Healthcare (Brewer), spoke with HCI Associate Editor Jennifer Prestigiacomo in a two-part interview.

Recently, the Washington, D.C.-based eHealth Initiative presented a one-day forum on the development of health information exchanges (HIEs). In conjunction with that event, held in the nation's capitol, the eHealth Initiative organization released the results of a nationwide survey of HIEs. Jennifer Covich, chief executive officer of eHealth Initiative, spoke with HCI Editor-in-Chief Mark Hagland regarding what was revealed in her organization's survey.

After Hurricane Katrina left death and destruction in its wake, Mississippi learned the value of the electronic health record, as physician practices that weren’t entirely flooded, dried their paper records on the sidewalk. Out of this tragedy sprung the hope of the Mississippi Coastal Health Information Exchange. James S. McIlwain, M.D., CEO and President, IQH & Co-Chairman of the Mississippi Health Information Infrastructure and Task Force Grant Administrator for the Mississippi Coastal Health Information Exchange, spoke with HCI associate editor about what challenges he and his team have been facing trying to put together the pieces of this coastal health information exchange.

Attending the eHealth Initiative’s one-day forum on health information exchanges (HIEs) last week in Washington, D.C., seemed to validate all the perceptions I’d been gathering over the past year about the challenges and opportunities inherent in the HIE concept at this point in time. On the one hand, some real progress is being made, in places as far-flung as Vermont, Louisiana, and Arizona. On the other hand, the path has been, and continues to be, remarkably difficult, for a wide variety of reasons associated with funding, governance, affiliation, process, and other issues. And the technology is the least of it, though there absolutely do remain some tech issues as well.