While health information exchanges (HIEs) continue to grow in number, those who are participating say sustainability remains an issue, according to the results of a new survey that appears in the latest issue of the healthcare policy journal Health Affairs.

As part of a larger report done by the Robert Wood Johnson Foundation, researchers counted 119 operational exchange efforts nationwide, which is a 61 percent increase from 2010. Overall, 30 percent of U.S. hospitals and 10 percent of doctors' offices are involved in one.

However, of those organizations who are involved in an HIE, 74 percent say they are struggling to develop a sustainable business model for it despite some progress. Furthermore, those in the trenches are concerned that the current efforts to promote HIE will fail when public funds supporting these initiatives are depleted. Of those surveyed, 52 percent were substantially funded by grants and contracts.

"What we've seen is this federal money really has made a big difference," stated lead study author Julia Adler-Milstein, an assistant professor in the University of Michigan School of Information and School of Public Health. "What hasn't really moved, though, is the perception that the organizations haven't figured out how to fund themselves, which will be a big problem after the government grant money runs out in January 2014."

In the study, the researchers note that payers participate in fewer than half of operational HIE efforts and pay to participate in an even smaller proportion of them. The researchers say this is troubling because payers are seen as the primary beneficiary of such exchanges, because it would reduce redundant tests and procedures.