There’s been a lot of talk lately about the future of health information exchange (HIE)—what it will mean 10, 15 or even 20 years down the road. There is no question that providers recognize the importance of HIE, and realize in combination with electronic health records (EHRs) that it will transform the practice of medicine. The question is whether providers are fully aware of the many HIE projects on the ground right now that already are beginning to impact patient care. As a result, providers can’t put off planning for HIE any longer; those who do risk lagging behind as others begin reaping its benefits.

VLER: blueprint for HIEs of today and the future

It is important to understand how some of today’s HIE projects will act as stepping stones for the entire healthcare industry as we continue making strides to connect federal and state health organizations, and eventually government and private sectors. One specific organization on the forefront is the Department of Veterans Affairs (VA), with more than a dozen different yet interrelated projects working together as part of its pioneering Virtual Lifetime Electronic Record (VLER) initiative.

The VA has long had a reputation for taking the lead on EHR initiatives, deploying its signature VistA/CPRS years ago. Now, the comprehensive VLER Data Sharing project is linking the VA’s clinical database with the Department of Defense (DoD) clinical database, resulting in a shared repository of information that includes more than 1,000 community-based outpatient clinics, 152 VA medical centers, 21 system networks, and the VA central office.

This project alone includes data on patient care that spans a broad range of treatment and knowledge, including 31 different clinical data domains, and many times follow a patient’s health throughout his or her lifespan. The HIE technology used will help improve the whole spectrum of care for 25 million veterans and their families. But what’s important to know is that this is not futuristic HIE: it is happening today. Currently in pilot testing, VLER just celebrated a major milestone by verifying actual information exchange for more than one million active dual consumers between the VA and the DoD. This becomes even more important with the advent of the James A. Lovell Federal Health Care Center in Chicago where DoD and VA beneficiaries receive care in the same facility. Furthermore, VLER already is connecting the VA and DoD with private civilian health systems, such as Kaiser Permanente and Richmond, VA.-based MedVirginia.

VLER is among the largest current HIE undertakings in both scope and size. It is positively impacting veterans’ care now, and is expected to serve as a blueprint for other HIE implementation activities. But it certainly isn’t the only active HIE. As previously mentioned, both Kaiser Permanente and MedVirginia have been approved to participate in the Nationwide Health Information Network (NwHIN)—a secure, nationwide, interoperable health information infrastructure. 

Act Now and Harvest HIE Benefits

Community HIE efforts already are contributing to a network of health information that is positively affecting patient care. As evidenced by a steady growth of new organizations joining each day, a strong existing member base and clear momentum, preparing for an HIE is necessary today.

Making HIE a reality for your organization will require planning now to invest in infrastructure and software to facilitate the exchange. Just as important, however, is determining how you will manage the patient data HIE enables you to access. And, moreover, you will need to implement the technology and processes necessary for knowledge management—data tracking, analysis, and reporting—that is such a critical component of HIE.

Without knowledge management, and the ability to predict care and service needs, the full value of HIE cannot be achieved. In an article titled “What Is Value in Health Care?” published Dec. 23, 2010, in The New England Journal of Medicine, author Michael E. Porter, Ph.D., notes that “Achieving high value for patients must become the overarching goal of health care delivery, with value defined as the health outcomes achieved per dollar spent.”

The HIE initiatives underway now are helping deliver that value. They are linking providers to one another and increasing access to patient demographic and treatment information, clinical research, treatment protocols, and outcomes from both the sequence of care and the long term benefits to the patient in both sustainability of health or recovery and the nature of any recurrences—just to name a few.  Therefore, the ultimate goal of these efforts is to improve the quality of patient care across the healthcare spectrum. Just as the creation of the Internet transformed the way businesses exchange information, deliver product, and meet customer needs, so HIE is beginning to enhance the way healthcare providers interact and work together to ensure quality patient care.

Larry Boland, FACHE, PMP, is the Director of Healthcare Solutions for Systems Made Simple, a company dedicated to delivering quality healthcare IT solutions to the country’s largest hospital and health systems to improve health care value for patients, providers, payers, and suppliers.