Barriers to sharing clinical data electronically among rival hospitals, doctors and health plans remain high as concerns about loss of competitive advantage and data misuse hamper participation in local health information exchanges, according to a study by the Center for Studying Health System Change (HSC) and the National Institute for Health Care Management (NIHCM) Foundation.
According to the study, the more mature exchanges — Cincinnati-based HealthBridge and the Indiana Health Information Exchange (IHIE) based in Indianapolis — have achieved “some viability” by meeting a specific business need for more efficient delivery of hospital test results to physicians. The newer exchanges — CareSpark, serving northeast Tennessee and southwest Virginia, and the Tampa Bay Regional Health Information Organization (RHIO) — have struggled to identify and finance initial services without a similar critical mass of hospital participation, according to the study.
The study’s findings are detailed in a new HSC-NIHCM Research Brief, “Creating Sustainable Local Health Information Exchanges: Can Barriers to Stakeholder Participation Be Overcome?” available online at http://www.hschange.org/CONTENT/970/
The study found that provider organizations still face substantial disincentives to share data with unaffiliated organizations. Beyond the hospital systems in Cincinnati and Indianapolis, stakeholders were unwilling to pay enough collectively for the same set of services to sustain HIEs. Generally, neither health plans nor employers were willing to fund core clinical data exchange as a benefit for patients. Employers typically also did not see themselves funding HIEs to support quality initiatives, and health plans had few incentives to deviate from company-wide pay-for-performance strategies to participate in local efforts, the study found.