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Report: Providers Looking for More out of HIEs

June 22, 2015
by Rajiv Leventhal
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Healthcare providers’ health information exchange (HIE) needs have moved beyond connecting disparate systems and meeting meaningful requirements. They are now looking for HIEs to ease access to “actionable” data, according to a report from NORC at the University of Chicago.

The researchers conducted an in-depth examination consisting of site visits and 37 semi-structured discussions in six states (Iowa, Mississippi, New Hampshire, Utah, Vermont, and Wyoming) in the early months of 2014 to understand provider perspectives on the state HIE program and their experiences with electronic exchange. The report was funded by the Office of the National Coordinator for Health Information Technology (ONC).

The report found that providers highlight the potential for HIE to ease access to actionable data that integrates data from across the care continuum and provides clinicians with information at the point of care to improve care delivery and care coordination. Providers highlighted several exchange priorities: admission, discharge, transfer (ADT) alerts, services that facilitate care coordination, and interstate exchange.

Additionally, meaningful use and payment reform are creating new requirements for health IT-enabled information sharing related to care coordination and management as well as new models for patient care. Providers anticipate a growing need for vendor provided HIE services and infrastructure as expectations for electronic exchange of health information increase under this shift, the report found.

Providers also encountered various challenges, specifically competing priorities, issues managing multiple funding streams, lack of qualified staff on the provider side, and difficulty obtaining adequate support from electronic health record (EHR) and HIE vendors. They also noted a need for interoperable systems to meet exchange and health system reform goals.

What’s more, providers in most states believed that the state HIE program contributed to building awareness around HIE and the benefits of exchanging information. Providers conveyed a general sentiment that a state-based HIE effort is important, due to their stature as neutral entity, capable of bringing stakeholders together. Even though the meaningful use program did not provide incentive payments to long-term care and behavioral health providers, the state HIE program was instrumental in engaging these providers, identifying their specific needs and the gaps that grantees needed to fill, particularly around care continuity, the report revealed.

The researchers concluded, “Throughout the life of the program, HIE has become more visible and better established, meaning that provider priorities and challenges have likewise evolved.” In addition to highlighting providers’ current needs and perspectives on HIE, findings from these conversations emphasize certain areas, the researchers said:

  • Providers have additional use cases beyond meaningful use and payment reform they are or would like to pursue to meet their specific exchange needs.
  • New healthcare system priorities, such as care coordination suggest expanding interoperable health IT systems and services to providers in eligible for meaningful use to ensure that the information needed to manage care is available electronically.
  • There is a need to push for interoperability at the vendor level.

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