Public vs. private HIEs: Room for both?

While private health information exchanges are non-reliant on government handouts and thus, slightly more self-sustaining, according to an article published in this month's Journal of AHIMA, they also, according to some, undermine efforts of public HIEs, which aim to connect providers for the greater good, rather than for greater profits. So the question remains: Is there room for both?

Steven Roth, chief medical information officer with Harrisburg, Pa.-based PinncaleHealth, believes there is. While Pinnacle created its own HIE in 2009--which has been operating with a profit for most of that time--it also has committed to join the Pennsylvania eHealth Collaborative's HIE, currently in progress.

"It makes sense to me that some public entity brings all of those [private] entities together, where there really isn't a motivation," Roth told the journal. State HIEs, he said, can help to fill the gaps left by private HIEs.

Others, including University of Utah School of Medicine professor Leslie Lenert disagree. The article points to a paper Lenert wrote at the beginning of the year that concluded that private HIEs and efforts like the Direct Project have undermined regional health information organizations and state-based HIEs.

What's more, a report released this week by Chilmark Research found that while the HIE market grew more than 40 percent in 2011, only a small portion of that growth resulted from the HITECH Act and statewide HIE efforts; rather, most of that growth was due to vendors targeting the private enterprise market.

A recent survey of hospital CIOs found that nearly 60 percent are currently involved in either a regional or system-to-system HIE effort, though roughly 21 percent said they were "skeptical" of HIE sustainability.

To learn more:
- read the Journal of AHIMA article
- here's Lenert's paper in JAMIA

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