Health IT: Moving forward--or sideways?


The health IT industry and the roles of its players are undergoing a shift. Although a panel of industry experts speaking at a roundtable forum hosted by National e-health Collaborative this week didn't necessarily agree on the impact of the changes, they all agreed that we're in the midst of a transition. Some of the changes include:

  • The shift from hub-and-spoke HIE architecture to internet-based point-to-point exchange
  • The move from Health Information Exchanges (HIE) as monopolistic public utilities to more internal, private data-sharing networks
  • The increase of private investment in HIEs and information exchange
  • The rapid change in the technologies and the capabilities of EHR products
  • The shifting role of HIEs as businesses, which must perform better, faster, cheaper
  • The commoditization of EHR capabilities, such as patient record look-up
  • The increased willingness to share patient data rather than hoarding it
  • Baby steps in the standardization of some EHR components

And of course, the rise in adoption of EHRs, spurred by the Meaningful Use incentive program.

"Reality is changing out from under us,"  noted Arien Malec, VP of data platform solutions for Relay Health.

But that's not necessarily a bad thing. While the roundtable was entitled "Implications of a Shifting National HIE Architecture," the conversation suggested we'll see an evolution rather than a shift--in other words, the industry will move sideways rather than forward. The panelists disagreed with certain aspects of these changes--such as whether different forms of HIE architecture should be used together--but there was no fire and brimstone, no major disputes as to what's occurring in the industry.

"It's more progress than a shift," Kate Berry, CEO of the National e-Health Collaborative told FierceEMR in an interview. "The incentive program did create a stimulus. It's driven significant progress to the deployment of EHRs and HIE from concept to reality," she said. In addition to the government's shaping of this progress, the market is innovating with new technology and initiatives and new business models.

"We're seeing that the transformation in payment is creating a more compelling business case for HIE," she adds.

Do these changes in the landscape affect our priorities? Not necessarily. Berry highlights that the industry needs to create a sustainable model that will support interoperability and enable different EHRs to talk to each other. Health IT and HIEs also need to be sustainable from a cost standpoint.

"Everyone needs to pay something. That's where business models are working. Government grants for HIE is not enough," she warns.

At the same time people need to work collaboratively and reach agreement as to what each community needs, building cooperation and trust--and putting less focus on keeping data and software proprietary.

"This is tough work. HIE is hard and it's not pretty. What keeps those in HIE going is that by doing this we will improve the quality and coordination of patient care. That's the most important priority," says Berry.

Hard to disagree with that. - Marla

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