The leaders of health information exchange (HIE) organizations are developing a wide variety of strategies, at a moment redolent with both challenge and opportunity. With the shift towards value-based healthcare delivery and payment accelerating, the need for effective data exchange between and among all the stakeholder groups—physicians, physician groups, hospitals, health systems, health plans, public health agencies, and state health departments—is growing by the day.
In that context, the need for interoperability is accelerating apace as well. Yet creating true interoperability is far more difficult in practice than in theory, particularly given that there is no “magic bullet” or easy approach that can fast-track a path to near-universal interoperability and data exchange. So what are the leaders of some of the most successful statewide HIEs doing to create successful strategies, and to help support their colleagues in moving forward?
One HIE leader who has been thoughtfully pondering these questions is John Kansky, president and CEO of the Indianapolis-based Indiana Health Information Exchange (IHIE). IHIE was founded in 2004; Kansky has been its CEO for nearly 11 years. IHIE’s network connects 117 hospitals, representing 38 health systems; 14,592 physician practices, representing 42, 215 providers; and 13,221,125 patients, and 10, 916,592,344 data elements, according to information on its website. Kansky spoke recently with Healthcare Informatics Editor-in-Chief Mark Hagland regarding his perspectives on the current moment in health information exchange, and the potential for breakthroughs in interoperability in the next few years. Below are excerpts from their interview.
What are your organization’s top goals in the coming months?
We’ve got a strategic plan that we’re in the middle of executing, that has three basic tenets to it. One is integrating our data within the EHR [electronic health record]. I’m sure you’re familiar with the general theme that many have expressed, that having a physician have to leave the general medical record is suboptimal. In that regard, we’re one of the nation-leading HIEs willing to do the heavy lifting around that. Number two, in the context of the patient-centered data home, we have to share data beyond state lines and in different markets. We have to figure out how to increase interstate health information exchange. And the third theme is helping our participants in terms of supporting them around population health.
You’re the statewide HIE, of course. Are there also local HIEs operating in Indiana?
Yes, there are; there is one in Bloomington, and there is one in South Bend, called Michiana Health Information Network, with South Bend being near the Indiana-Michigan border. And that relates to another theme: we’re very collaborative and cooperative in our approach. And both of those HIEs are connected with us and are exchanging data, in the context of our patient-centered data home. It’s important for HIEs to take the perspective that if your state needs data in another HIE, you need to help get the data for them. My joke is, if you can’t make a long-distance call from South Bend to Indianapolis, something’s wrong with the phone system; and the data shouldn’t be any different [in terms of its connectivity].
So what would you say about the state of interoperability right now across U.S. healthcare, in this context?
I was on an ONC [Office of the National Coordinator for Health IT] panel last week Tuesday in Washington, and it was interesting discussion. Right now, most healthcare IT professionals have a very superficial understanding of the different interoperability approaches; and because their understanding is still rather superficial, there’s this idea that there’s a single best approach. And the federal government wants to know who’s got this interoperability thing figured out, and what’s best for the country? And obviously, healthcare IT professionals want an answer that’s no more complicated than it needs to be. But it’s wrong to try to simplify it down to one interoperability approach, because the various approaches do different things, focus on different things. And we often say here at IHIE that interoperability is not one “thing.”
There’s massive confusion around that in the field, right?