With 43 percent of facilities considering moving to an Accountable Care Organization model and 45 percent of respondents seeking to improve connectivity within their health systems, HIEs are more top of mind than ever, according to a recent Porter Research and Billian’s HealthDATA (Atlanta, Ga.) survey. The survey of more than 120 C-suite/director- level health executives, showed however that cost and funding are still the biggest barrier for exchanges. Cynthia Porter, president of Porter Research, spoke with HCI Associate Editor Jennifer Prestigiacomo about the current climate surrounding HIEs and what are provider’s true perceptions.
Healthcare Informatics: Were there any findings in this study that you found surprising?
Cynthia Porter: One thing was that 63 percent of our respondents believe that patients will benefit from HIEs. We also had asked them to rank their organizations in terms of the HIE requirements for meaningful use. Nearly half rated themselves as mostly prepared for Stage 1, but what I found interesting is that 10 percent said they were ready to meet the requirements for Stage 2 and 3. And why that’s so interesting is that requirements for Stage 2 and 3 aren’t out yet. These results echo those of a recent CHIME study where the percent of CIOs who expect their organizations to qualify for meaningful use incentive payments dropped from 28 percent to most recently 15 percent. You really got to look at some of these organizations on a case by case basis to get a true picture of where we are at this stage. So, I found that this ranged all over the place from people being prepared and ones that didn’t even know.
HCI: Why do you think that respondents, when asked who benefits most from the HIE, had such low responses for “physician” and “health system”?
Porter: The physicians and the hospitals are going to have the costs associated with an HIE. And this not only includes finding the budget, but finding the resources, the technical challenges, and the political challenges with sharing information between separate legal entities. If you look at patients, they are the immediate true winner, and they really don’t have any cost now associated with an HIE. The other area that came up to be the second winner is the community.
HCI: Why do you think the centralized data warehouse was the preferred data architecture for HIEs?
Porter: Cost and security are the number-one reasons. Centralized data warehouses are the first step to cloud computing, which is really three to five years away. Cloud computing really has enormous benefits. What they really focus on is the new delivery model which includes the ACO and the medical home. I believe the providers are very hesitant to adopt cloud computing at this stage because they’re still worried about security. But the cost effectiveness of this kind of service will probably outweigh security concerns, especially after more and more providers find out how effective the cloud is through platforms like HIEs.
HCI: Why do you think there are so many organizations out there unsure about which HIE vendor to consider?
Porter: From our study, 48 percent of the market was not sure who was even a market leader. Forty percent weren’t even sure who they’d consider. The HIE market, even though it’s been around for about 20 years, is still a very immature market where even the industry leaders have very small revenues and a small client base. CIOs at hospitals, they’re used to making decisions about technology for the inside walls of their hospitals, for example a radiology system. But the selection of an HIE solution impacts not only the hospital, but the owned affiliates, the clinics, the laboratories, the imaging centers. There are so many more stakeholders’ fingers in the cookie jar. I think when we go to HIMSS we’re going to see over 55 vendors—I bet you even more—saying that they’re an HIE vendor.
HCI: What does the split between those who wanted a company solely focused on interoperability vs. their current acute EHR vendor for their preferred supplier type tell you?
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