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Rise of the Private HIE

November 3, 2010
by David Raths
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Single health system exchanges could outpace RHIOs due to already established relationships

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.



Thanks for the comment. I wonder in the second scenario you mention whether they will link into a community HIE once it is up and running or if they would see that as negating the competitive advantage they have identified...

David - Great point - Both the California and Puerto Rico implementations are exploring ways to share their data with the larger community in their respective regions. What we are finding is that other groups that are looking to form their own HIEs in the same region are looking at a way to expand the exisitng infrastructure rather than have a completely seperate infrastructure. If it is the same infrastructure, there needs to be the appropriate security and privacy parameters in place so that one groups data is not migled or able to be accessed by another group. This is based on the governance of the multiple organizations and what is agreed to by all parties.

David - Great post - I beleive that you will see more and more of these private HIE's - There are two scenarios that I see. Either there is no state or regional HIE in an area and so the the health system will create it themselves. The other scenario is where there is a HIE in the region, but for competitive reasons, the local hospital wants to have their own mechanism to connect to their own community providers in the hopes that those community providers will continue to refer patients to their institution and not the one across the street.

Here is an Healthcare Informatics posting of other private HIE's in California and Puerto Rico.