Despite recent HIE initiative growth, sustainable exchanges rare

The number of health information exchange (HIE) initiatives rose 9 percent to 255 in the past year, according to the latest national survey by the eHealth Initiative. At the same time, the number of "advanced" or operational HIEs advanced to 85 in 2011 from 73 in 2010.

The number of HIEs with sustainable business models, however, remains low. Just 24 HIEs reported they were "sustainable," meaning they could support themselves without government or private grants. In 2010, 18 HIEs said they were sustainable.

It's unclear how much impact the new federal HIE grants, totaling $564 million, have had on HIE development. These grants, which were made to state agencies or state-sponsored entities earlier this year, may not have trickled down to regional HIEs before they were surveyed.

What is clear is that the multi-stakeholder initiatives examined in the eHealth Initiative report are growing more slowly than HIEs sponsored by healthcare systems to connect their own units, as well as employed and affiliated physicians. A recent KLAS survey found that, while the number of "live" community HIEs increased from 37 to 57 in the past year, the number of private HIEs more than tripled, from 52 to 161.

The eHealth Initiative survey found that the majority of operational HIEs offered at least one service that helps providers meet Meaningful Use requirements. A majority of all HIE initiatives planned to incorporate the new Direct Project protocol to move information from one provider to another. About one-quarter of the initiatives said they would support accountable care organizations.

To learn more:
- read the press release (.pdf)

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