Super-sized HIEs rise up nationwide

Even as some health information exchange projects fail, others are rising to take their place, and some are quite large. The two latest examples are regional HIEs in western Pennsylvania and southern California.

The ClinicalConnect exchange in Pennsylvania will include nine of the area's health care systems. Among them are Altoona Regional Health System, Armstrong County Memorial Hospital, Butler Health System, Excela Health, Heritage Valley Health System, Jefferson Regional Medical Center, St. Clair Hospital, The Washington Hospital and the University of Pittsburgh Medical Center (UPMC).

Starting with a pilot at Heritage Valley, ClinicalConnect will be implemented over the next two years. There are plans to bring in other regional health systems in the near future.

One of the neighboring systems is Western Penn Allegheny Health System (WPAHS), which is being sold to Highmark, the largest insurer in the area. Highmark, Western Penn Allegheny, Allscripts, and Accenture are partnered in a program to induce more small practices to adopt electronic health records.

The new HIE in southern California promises to be even bigger than the one in the Keystone State. The Inland Empire Health Information Exchange covers San Bernadino and Riverside Counties, an area nearly as large as Maine with a population of 4.5 million. About 15 hospitals and 2,000 physicians are expected to participate in the HIE, according to California Healthline. Yet the Inland Empire exchange is only one of 17 Golden State HIEs that eventually will coalesce into a statewide data exchange.

The membership of the Inland Empire Exchange, which will use a subscription-based financial model, is unusually broad. It encompasses not only doctors, hospitals, and community clinics, but also a Medicaid plan--the Inland Empire Health Plan. Between the state's plan to transition Medicaid recipients into managed care and the Medicaid expansion mandated by healthcare reform, the Inland Empire plan expects to have 900,000 members by 2014. It views participation in the HIE as a way to control health costs.

What's striking about this approach is that a health insurer sees value in joining and contributing to an HIE. But it may not be unique. If Western Penn Allegheny ends up joining the ClinicalConnect HIE, Highmark will become at least a de facto member of that exchange.

To learn more:
- read the Healthcare IT News article about ClinicalConnect
- read the California Healthline piece about the Inland Empire HIE
- see the InformationWeek Healthcare story about the Highmark-Allscripts deal