Lessons from an HIE pioneer

It has taken multiple efforts, but the latest effort at health information exchange that Joe Heyman, M.D., has been involved with is close to success, reports Medical Practice Insider.

Heyman, formerly an Americal Medical Association (AMA) board chairman and president of the Massachusetts Medical Society, runs a solo gynecology practice two days a week in Amesbury, Mass. The rest of the time he focuses on the data exchange created by Whittier Independent Practice Association in Newburyport, Mass. Earlier this year it began combining data from disparate sources into a single record for each patient.

Heyman has been working on exchange efforts since 2005. A big takeaway from his experience, he says in Medical Practice Insider's Q&A, is to make sure everything is working before making it available to patients--a lesson for all health IT, as the HealthCare.gov creators certainly learned the hard way. Heyman said thorough testing will be done as each practice comes on board.

Cost has been a big barrier in previous attempts at exchange. Its current technology vendor offered a lower entry price, with price increases as the organization grows. Community HIEs can't continue to depend on grants and have to find a way to be sustainable, he said.

The HIE plans to include records from 17 different medical record vendors. It also will connect with the Massachusetts Health Information Highway, which will make Direct Messaging available. It has three physician practices on board so far, including a large pediatric practice, and just signed up another 80-member group.

Interoperability and sustainability are among the biggest hurdles that HIEs face, according to the eHealth Initiative's 2013 Health Data Exchange Survey. Its report calls interoperability "a great hurdle with little relief in sight" and found just 26 percent of responding organizations indicated that they received sufficient revenue from participating entities to cover operating expenses.

University of Michigan research found a 61 percent increase in the number of HIEs since 2010, yet 74 percent of the exchanges reported that they're struggling to develop a sustainable business model.

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