When we think of health information exchanges, we usually picture regional efforts at collaboration across multiple provider organizations. And most articles about HIEs focus on the governance, privacy and security and funding issues they all must address.

But there is another type of HIE quietly developing, one that is sponsored and run by a single health system. I just came across a great description of one by executives of five-hospital Main Line Health (MLH) in Pennsylvania.

Harm Scherpbier, MD, MLH’s vice president and chief medical information officer, and Joel Port, vice president for planning and business development, note that the 2,000 physicians on its medical staff, most in private practice, are now in the process of choosing their own electronic health record systems, and there is no regional health information organization available yet to link them. Writing in the Fall 2010 issue of the Health Policy Newsletter put out by the Jefferson School of Population Health in Philadelphia, Scherpbier and Port say that their enterprise HIE “creates a mechanism for connecting all these disparate systems through an electronic medical highway developed for our community physicians and other providers, supported by MLH.”

MLH has partnered with Warminster, Pa.-based tech firm MobileMD on a connectivity engine to handle three functions: formatting transactions, terminology mapping and routing data to the right provider.

To date, MLH has connected 20 practices with 30 more in the pipeline. So far, data flow is just one way, with physicians receiving lab results, radiology reports and dictated reports, but soon two-way traffic will allow providers to share data among practices.

As regional and statewide HIEs slowly develop, these private HIEs may initially outpace them because they are based on already established business relationships and don’t require building consensus among competing stakeholders. It will be interesting to see how these two types of HIE dovetail or diverge in the years ahead.