Doc: HIEs on a 'promising path toward success'

The healthcare industry should not give up on health information exchanges (HIEs), which continue to evolve and progress, according to a new viewpoint article in JAMA Internal Medicine.

Anish Mahajan, M.D., of the Lost Angeles County Department of Health Services and Los Angeles Network for Enhanced Services, notes in the post that many see HIEs as only a "pipe dream." Although HIEs--for which billions of dollars have been invested--can improve patient safety, outcomes and coordination of care, as well as efficiencies, their future remains "unsure" at best, he says.

Mahajan cites problems with HIE viability related to the business sustainability of the entities that operate HIEs, the lack of interoperability of electronic health records, difficulties doctors have had in adopting EHRs, data security and hospitals' concerns about losing market share.

But he adds that health information exchange, overall, is still in its "early stages."

For instance, alternative payment models like accountable care organizations and Medicaid managed care programs provide a strong incentive for providers and health plans to participate in HIEs; these evolving models of payment and advancing technology offer a "blueprint" for the design of data exchange and the services HIEs should provide.

Mahajan recommends that more work is needed to support such exchanges, and says instead of being vendor- or network-centered, HIEs must be patient centered. That, he says, will ensure health information follows a patient across all delivery settings.

"As health information exchange matures in its core objectives of improving care and care coordination, new functionalities, such as establishing consumer-accessible longitudinal personal health records and making clinical data available for public health surveillance and intervention, should become important goals of such exchange," he writes.

While HIE use has increased, usage is still low. Moreover, different HIEs compete with each other for providers' attention and resources, causing some to struggle. A few HIEs have begun to offer additional services in order to boost participation.

To learn more:
- here's the abstract