With the Office of the National Coordinator (ONC) encouraging providers to adopt Direct, many state health information exchanges (HIEs) are shifting their focus to Direct as a way for providers to meet meaningful use criteria. Florida, like Tennessee and Oregon, is keeping infrastructure costs low and lean to remain sustainable after ONC funds run out.

Florida HIE’s main strategic goals are to gain a critical mass for its two main services, Direct Secure Messaging and Patient Look-Up, and provide more value as more providers join, says Janet Hofmeister, program director for the Florida HIE. As the Florida HIE grows, the cost of the services will marry with the organizational size; those who gain the most benefit will pay more.

“We tried to keep our infrastructure very lean, so we use a lot of open source components,” says Hofmeister. “When we do purchase licenses we do a good job negotiating with our partners to get a good deal.” She references the unlimited number of light licenses their software provider (the Irvine, Calif.-based Mirth) threw in with the purchase of the full exchange software suite.


Janet Hofmeister

The Florida HIE was created in 2010 from a four-year $20.7 million ONC grant administered to Florida's Agency for Health Care Administration (AHCA). The Florida HIE went live in June 2011 with Direct Secure Messaging to offer providers a lightweight exchange service. Florida HIE also offers a Patient Look-Up service, which allows retrieval of records from multiple data sources at the point of care after patient consent. The patient matching is based on patient demographics.

Currently, the Florida HIE has more than 900 providers—mostly in smaller physician practices—signed up for the Direct messaging service. In August, Florida HIE made an agreement to share Direct Secure Messaging capability with the Care360 suite of solutions from Quest Diagnostics, which will enable the Florida HIE to connect with all users and providers of the 11,000 physician offices in Florida currently using Care360.

Beyond strategic partnerships, Florida HIE has reached out to 23 of the 67 county health departments to gain more participants. “We’re signing up the providers who actually work for the county health departments, and we’re asking them who do they regularly communicate with,” says Hofmeister. “Then we’re reaching out to those groups of providers, physician offices, etc., and we’re signing them up. And that has been very successful.” 

Florida HIE is in the process of spreading the word of its Patient Look-Up service to hospitals and health systems about at local industry conferences and partnering with the South Florida Regional Extension Center, Atlantic Coast HIE, Big Bend Regional Healthcare Information Organization, and Strategic Healthcare Partners to increase awareness.

Hofmeister admits that since many Florida providers have been involved in adopting electronic health records (EHRs), it has been a slow start to unroll these basic services. She also notes it has taken longer than expected to sort out the necessary legal and HIPAA issues.

Future HIE services are still being determined, but specific use cases like connecting providers and pharmacies are being considered to add value.