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Connecting to an HIE — The Good, the Bad, and What it Means to You

Written by Dennis Sherba, Practice Director, Connected Community, Professional Services, Iatric Systems

PS-Challenges-of-Connecting-to-an-HIE.jpgConnecting to an HIE and achieving true Interoperability are challenges CIOs face on a daily basis. This is evident based on the number of industry publications that cover this topic almost every day. It’s because the challenge of sharing patient data across disparate systems, and achieving interoperability, are very difficult things to accomplish. And every hospital’s situation is different, which contributes to the complexity.

Some industry experts are even proposing alternatives to HIEs, saying that HIEs are not sustainable (which a lot of them aren’t). However, these alternatives have not yet received widespread adoption. This topic is discussed by Ann Zieger in a post on the Hospital EMR & EHR site. So, should you spend the time and resources to join your State HIE, a Regional HIE, or develop your own Private HIE, or something else all together?

The answer to this question is, it depends on your goals and the status of the regional and State HIEs in your area. The options are all over the map — so to speak.

Our team recently facilitated a focus group about interoperability at HIMSS16, and one CIO said, “We were connected to our state HIE, but the only data we were getting back was our own, so we stopped…”

There is no doubt that the holy grail of true nationwide interoperability is a long way off. Even the ONC is doing outreach for suggestions on metrics to quantify progress towards true interoperability. If you ask 10 people what interoperability means to them, you will get 10 different answers, and all of them are valid. This is also true in relation to the benefits and goals of hospitals connecting to HIEs. The questions are endless:

  • Should I connect to my state HIE or a Regional HIE?
  • Should I create my own private HIE between my hospital systems?
  • What data do I need to send to the HIE?
  • What’s involved in connecting to an HIE (budget and logistics)?
  • What benefits am I going to get from doing so?

…And so on and so on…

The answers to these questions are not straight forward. Because each hospital and HIE situation is different, you really need to do your own evaluation to see what is right for you.

The first thing to find out is how successful is your own state HIE, and what benefits will you get from participating.

A few states are seeing increased adoption of their HIE. This is detailed in a Modern Healthcare blog post that talks about how the multi-million dollars in federal funding have produced some gains, and some failures. The results come from a report commissioned by the Office of the National Coordinator for Health Information Technology at HHS.

According to the report:

  • The total number of directed transactions through the HIE increased threefold
  • The total number of patient directed queries increased fourfold
  • Although these numbers represent considerable growth, according to the report, national averages of participation were driven by a small number of top performing states, rather than by high participation across all states

The report states:

“Together, these results indicate a positive trend in HIE adoption and use, across the program years, states, and multiple services. Nonetheless, adoption and use varies heavily by state and many opportunities for expansion remain."

Why are some hospitals successful in connecting to HIEs, and receiving benefits, but others are not? The answer may lie with your EHR.

A recent article by HIEWatch titled “Providers and Payers blame interoperability issues and data blocking on EHR vendors, turn to Private HIE” states:

“In addition to the 57 percent of survey respondents who blame EHR vendors, in fact, 20 percent cited government agencies for being too slow to develop standards that advance interoperability. And 17 percent said executive leadership at their organization is not interested enough in making interoperability and health information exchange happen soon.”

So, as you can see, there is not one right answer. It comes down to how strong your HIE is in your state, what systems you have in place, and what your goals are for exchanging information.

For answers to more in depth questions, and how you can get help determining your path forward with HIE, Population Health, Patient Identity, and other topics, check out this eBook:

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Topics: Interoperability, HIE, integration, Health Information Exchange

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