HIEs evolving as demand increases

Both health information exchanges (HIEs) and providers' needs regarding them have evolved since HIEs were first launched, according to a new report from NORC at the University of Chicago researchers for the Office of the National Coordinator for Health IT.

The report, released June 19, examined HIEs from March through May 2014 in six states: Iowa, Mississippi, New Hampshire, Utah, Vermont and Wyoming. The researchers found that providers' HIE needs have moved beyond simply connecting disparate electronic health record systems and the need to meet Meaningful Use requirements into more of a desire for information at the point of care to improve healthcare delivery. For instance, some of the priority items providers are pursuing or would like to see include admission, discharge and transfer alerts, care coordination and interstate data sharing.

Meaningful Use and payment reforms also were creating new requirements for data sharing, and state-based HIEs were seen as important, especially since they were neutral and engaged providers who were not Meaningful Use participants.

Some of the challenges with HIEs providers identified included the need for more sophisticated infrastructure and services, the high cost of HIE participation, competing priorities, the lack of tech-savvy staff, the lack of interoperable systems and the lack of standardization at the vendor level.

"Awareness of and demand for HIE has been steadily increasing throughout the life of the program," the report states. "Providers we spoke with in previous and current activities reported an appreciation for the state HIE program's role in communicating with providers of all types, bringing together stakeholders, and communicating the value of HIE. Now that HIE is better established--both in terms of visibility and available services--providers have identified new priorities and challenges.

"These have evolved from early issues surrounding basic implementation and awareness of the benefits of HIE into a search for solutions to meet greater demand for information, while balancing cost and multiple information exchange priorities," the authors wrote.

HIEs have come under fire due to operational problems and privacy concerns by patients. However, some studies have shown that HIEs can deliver more efficient and cost effective healthcare. ONC has invested $564 million in order to establish state HIEs.

To learn more:
- here's the report (.PDF)