The Health Information Exchange Hearing

The Standards and Policy Committees met on Jan. 29 in Washington in joint session to take testimony from expert stakeholders about health information exchange.

Farzad Mostashari, National Coordinator, introduced the day, noting that we've made great strides since the founding of HL7 in 1987 and the creation of ONC in 2004, but there is more work to do. The includes early successes, a discussion of barriers/challenges, the elements needed to ensure trust, and the role of consumers. The hope is that the foundation laid by Meaningful Use stage 2 will enable reduced costs (and reduced vendor pricing for interfaces), increased benefit, and privacy protections that have not been historically possible.

Micky Tripathi, CEO of the Massachusetts eHealth Collaborative provided an overview of the  current landscape in his presentation, The State of Health Information Exchange. He described HIE 1.0 as the noun and HIE 2.0 as the verb with many models (in order of increasing level of external coordination needed):

  • Point to patient
  • Point to point
  • Vendor specific
  • Transaction specific national level
  • Enterprise level HIE organizations
  • State and regional collaboratives
  • National level collaborative

Next, I moderated a panel, Health Information Exchange Enabling Healthcare Transformation, describing the technology and policies which have enabled successful health information exchanges. The major lesson learned was workflow and business value are even more important enablers than technology. We heard from:

Michael Lee, Atrius Health

Sandy Seltzer, Camden Coalition

Keith Hepp, HealthBridge

John Blair, Hudson Valley Initiative

Karen VanWagner, Plus ACO/North Texas Specialty Physicians

Next Paul Tang moderated a panel, Technical and Business Barriers and Opportunities, which concluded that meaningful use stage 2 significant reduced technology and policy barriers by constraining optionality in standards and aligning incentives to exchange data. We heard from:

John Halamka, Beth Israel Deaconess Medical Center

David Horrocks, CRISP

Bill Spooner, Sharp

Tone Southerland, Greenway

After lunch, I moderated a panel, Governance Barriers and Opportunities, which focused on governance and trust fabric efforts necessary to ensure authentication and authorization of participants in health information exchange. We heard from:

David Kibbe, Direct Trust