HIE execs' squabble leads to ban on connectivity fees

A heated exchange between chief executives of two health exchanges in Kansas led to the board that regulates them to decree that networks cannot charge each other connectivity fees until at least 2015.

The strong words were between Mike Dittemore, chief executive of the Lewis and Clark Information Exchange (LACIE)--which connects doctors primarily in metro Kansas City--and Laura McCrary, chief executive of the Kansas Health Information Network (KHIN)--which connects doctors all over the state, but not on the Missouri side of Kansas City.

The quasi-governmental Kansas Health Information Exchange (KHIE), in licensing the two networks, required them to be interconnected by July, though in its Wednesday meeting moved that deadline back to December, reports the Kansas Health Institute. Once connected, they each could receive $500,000 in federal incentive payments.

However, on May 9, KHIN notified LACIE that it would require a fee as part of its agreement to connect. LACIE refused.

"We will not pay another [network] to connect. That's never been the intent or spirit of this group. We certainly want KHIN to be successful, but we will not subsidize them," Dittemore told the board.

McCrary said it can't afford to give its data away for free, and accused LACIE of offering providers lower fees while promising them they could still get access to KHIN information for free. Dittemore called that a lie. That led the board to issue the ban on connectivity fees.

KHIE, meanwhile, has its own drama. Its board of directors voted last September to dissolve itself and turn its operation over to the Kansas Department of Health and Environment. That transfer goes into effect July 1.

Sustainability beyond federal incentives remains a huge issue for HIEs. Authors of an article published last September in Perspectives in Health Information Management said that exchanges must develop metrics to gauge their impact on quality improvement and show return on investment to continue to convince stakeholders of their value.

Earlier this year, McCrary and Joy Duling, executive director of Central Illinois Health Information Exchange, spoke with FierceHealthIT about the importance of starting with the right structure.

To learn more:
- find the Kansas Health Institute article