The organization building Tennessee's statewide health information exchange has dissolved after the state cancelled its contract in June.
The Tennessee Office of eHealth Initiatives plans instead to adopt the federally developed Direct Project protocols for secure messaging of health information.
The Health Information Partnership for Tennessee was created in 2009 to provide the infrastructure for the exchange, which was to be a "network of networks" for regional health information organizations, according to an announcement. The state has three regional networks--MidSouth eHealth Alliance, Middle Tennessee eHealth Connect and East Tennessee Health Information Network -- that plan to continue efforts for a statewide exchange.
The state received $11 million in federal funds to create the exchange, and Keith Cox, CEO of Health Information Partnership told Health Data Management that a "substantial" amount of that remains, though he declined to state a figure.
He said the work of the Axolotl health information exchange unit of OptumInsight was satisfactory and was not a factor in the state's decision to change directions.
Nearly 30 states are using the Direct Project clinical messaging protocol, and a dozen more are scheduled to inaugurate Direct this summer. The protocol is seen as a way jump-start online information exchanges among providers, not all of whom use electronic health records.
It uses the SMTP Internet protocol to exchange clinical messages among trusted parties. It enables physicians, hospitals, labs, other providers, HIEs and state health departments to send care summaries, referrals and other data online without dedicated interfaces.
Micky Tripathi, president of the Massachusetts eHealth Collaborative and an expert on health information exchanges, recently warned exchanges against trying to do too much too fast. He urged the industry to work toward short-term, incremental gains that can bring positive results.
And a report from the Healthcare Information and Management Systems Society's (HIMSS) State Advisory Roundtable says that exchanges likely will have to change their business models as government policies promote a transition from fee-for-service to value-based reimbursement. That likely will mean 'health information exchange' will need to become 'health care coordination facilitation.'