Achieving HIE Sustainability: Leveraging Information to Realize Success

The day is rapidly coming when healthcare providers across the country will be able to share information about patients with a few clicks of a mouse. Key to this future, at least initially, is the formation of health information exchanges (HIEs)—entities that electronically mobilize disparate health information and share it among providers, payers, facilities, pharmaceutical companies, biotech firms and a wide variety of other healthcare organizations. 

As we all know, HIEs take data beyond the walls of individual hospitals or physician's offices so that individual patients, larger patient populations and organizations can benefit from compiling, comparing, contrasting, and mining data. Without HIEs, the work currently underway in many healthcare organizations to track detailed patient care metrics loses its potential for more global value.  

Like any business, however, an HIE will only be successful if it is sustainable. That means achieving profitability without relying on grants or public funding. Unfortunately, most of the 255 HIEs that currently exist in the United States have not yet met this criterion; merely 18 have reached the point of sustainability.

There are many reasons for this overwhelming lack of solvency. A recent article in Government Health IT, for example, outlines five potential roadblocks HIEs face—data sharing, patient consent, standards, complexity and competition.  While all these factors certainly need to be addressed for long-term HIE success, the greater problem facing HIEs right now is the cost and relatively slow pace associated with the integration of disparate data sources.

More specifically, the amount of effort required to create a system that efficiently integrates, harmonizes and manages patient data in a usable way can be staggering. The data integration and mapping processes alone are complex and time intensive, demanding a high level of expertise and a long-term commitment to effective management.

Speeding integration: the overlooked need

There is no doubt that healthcare organizations perceive value in patient information integrated from disparate sources across the healthcare continuum. However, it is the speed with which data can be integrated and aggregated that will likely mean the difference between sustainability and defeat for many HIEs.

It makes sense if you consider the idea of “critical mass.” Achieving profitability without relying on grants or public funding means HIEs must find ways to make their data profitable. Healthcare and life sciences organizations—including payers—are most likely to both provide and subscribe to data that: 1) exists in large enough volumes, and 2) is aggregated in usable ways.