The vision of HIE: 'Knowledge is power'

Health Information exchanges have encountered a few road bumps, but the industry is making progress in using HIE to "harness" information and communication to improve patient care, accosting to Robyn Rontal, MHSA, JD, Director of HCV Data Analytics for Blue Cross Blue Shield of Michigan.  

"At a basic level everyone can get involved. ... Make sure your interests are represented," she said, speaking on a recent webinar held by the American Bar Association's Health Law Section.

Rontal noted that the vision of HIE is to use knowledge to improve decision making, pointing out that "knowledge is power."

However, she said, HIEs are being challenged by several practical and legal issues, regardless of their governance model. Some of those obstacles, according to Rontal, include:

  • Different privacy laws from state to state impeding interstate data exchange
  • Confusion as to which entity is responsible for HIPAA compliance along the continuum of HIE data exchange
  • How patients should consent to their data being shared on an HIE
  • The lack of interoperability
  • Patient identification concerns
  • Financial sustainability of the HIEs

There also have been early success stories, Rontal said. For instance, readmissions in Maryland are down from 18 percent to 11 percent due to better patient follow up attributed to its HIE. Several health systems, such as Salt Lake City-based Intermountain Healthcare, attribute lower costs of care and better outcomes due to HIE.

"HIE is a journey," Rontal said. "We hope to improve the system in the long run."

The U.S. Department of Health & Human Services has taken a relatively hands off approach to HIE, opting not to promulgate regulations regarding HIE governance, instead providing voluntary guidance. The Government Accountability Office recently chastised HHS for its lack of strategies to accelerate interoperability, telling the agency that it needed specific priorities and a way to measure its progress.

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