Lots of interesting tidbits were shared at the eHealth Initiative 2011 National Forum on Health Information Exchange at the Omni Shoreham Hotel in Washington, D.C., last Thursday, July 14, headlined by HHS CTO Todd Park. There were so many great thoughts shared about health insurance exchanges, health information exchange analytics, HIE sustainability models, and more, that I decided to bullet point them before I forgot them.

• During the day’s first panel “Transforming Healthcare Through Analytics,” Carladenise Edwards, Ph.D., CEO, Cal eConnect, had some fabulous insights on how to promote security within HIEs. Edwards said that only through greater consumer education on what data HIPAA permits to be shared, can we quell Americans’ fear of HIEs. She noted that HIE creators needed to get to the bottom of what consumers were really scared of, saying it’s not really an issue of fear of their data being shared, the actual fear is a data breach or the wrong people having access to personal data. The fear most people have, she said, was the outcome of a breach like higher insurance premiums or employer discrimination. She advocated for a renewed vigor to create policies to focus on breaches, rather than focusing on the technology around allowing consumers to limit which information is shared with whom.
  
  Edwards also said state designated entities had opportunities to “create vehicles for increased transparency and consumer information” within the triangle of the goals of healthcare reform, ACOs, and HIEs. “I think the states in collaboration with the ONC should look at a way to take a little piece [of the overall ARRA funding] and create that virtual transparency and come up with a way of melding some of those resources for the ACOs and the HIEs to create a nice, user-friendly tool or application that takes us to the next level of [consumer] decision support,” she said.
• During the “How HIEs can Work with the Direct Project” panel, Jeff Blair, director of health informatics, New Mexico Health Information Collaborative, said that even though he has a less populous state than others in the nation, his organization cannot feasibly reach out to all rural practices. And that’s where he said he realized the beauty of the Direct Project. “We’re looking at Direct to complement our main HIE,” he said. What came up over and over in this panel (and also what HCI Editor-in-Chief highlights in his forthcoming August cover story) is that Direct is not a panacea for information exchange, but rather an additional protocol for secure messaging. Blair said aptly that interoperability is a continuum, as “we try to move closer and closer to nirvana which we call plug and play.” The Direct SMI framework, he said, can get the industry a little closer. “The piece I worry about is the small practices because they don’t have a lot of resources,” he added.
• A consistent theme in the “Insurance Exchanges and HIE: Coordinating Efforts for Success” panel was that synergies can be derived from collaborating resources between state HIEs and HIXs. Both Kim Davis-Allen, statewide HIT coordinator, Alabama Medicaid Agency, and Edward Dolly, deputy commissioner, state health information technology coordinator, West Virginia Bureau for Medical Services, said that their states were leveraging resources and lessons learned from their HIEs to drive planning for their health insurance exchanges. Davis-Allen noted that if an HIE has good population data, this information can be translated to the HIX, so patients can see which health plans are best for them and health plans can additionally use that population data to structure better benefit packages to speak to the populations they serve. Scott Devonshire, CIO, Massachusetts Insurance Exchange, hoped that from his organization’s could capitalize on its early success, and go even further by using provider directories created from HIEs. He also said Massachusetts plans to embark on a publicity campaign, partnering with the Boston Red Sox, using radio ads, TV spots, and direct mail to educate the public on changes in the HIX in light of future ONC regulations.
• Micky Tripathi, Ph.D., president and CEO, Massachusetts eHealth Collaborative, shared some slides (see below) in the “Getting to Meaningful Use Through HIE” panel he moderated, which did a great job of showing what new requirements for HIE would be coming for Stage 2 meaningful use.

eHealth Initiative 2011 National Forum on Health Information Exchange


eHealth Initiative 2011 National Forum on Health Information Exchange

• In one of the most eagerly anticipated panels, “Staying Alive in 2011: Different Revenue Models for Sustainability,” Christopher M. Henkenius, program director, NeHII Inc., said that in addition to employing a license model, NeHII was planning to offer HISP services and cyber liability/security assessment services to help sustain itself. “We’re doing it to benefit the providers, and it benefits the exchange too,” Henkenius said. “We have to know [providers are] secure and that those who are accessing [the HIE] are accessing for the right reasons, and cyber liability/security assessments are a way for us to do that, while at the same time giving providers a sense of security.”
• 
  Keith Hepp, president and CEO, HealthBridge, said one misstep his organization made early on and learned from was deploying registries before it was able to pull data out of EHRs. He said that in the future he’d like to decrease the subscription price and use the Beacon funding his organization received as a capital investment to build on CCD transport. “I think transport is going to be free within five years,” he prophesized.