6 tips for HIE sustainability

The widespread development of health information exchange is happening quickly, and with it comes worries about confidentiality, privacy and security. But its benefits far outweigh potential concerns and include improved quality of care and reduced healthcare costs. 

Despite HIE’s reserved reception among hospitals and practices nationwide, many have said it will play a significant part in meaningful use stages down the road. And since there’s no time like the present to get a jump start on beneficial programs, Rob Brull, product manager at Corepoint Health, suggested six tips to make HIE implementation last.

[See also: Rural Washington collaborative building HIE.]

1. Keep it simple. According to Brull, HIE can do a lot when it comes to improving the quality of patient care. However, he thinks it’s best to focus on a few aspects of HIE that will have the biggest impact. “If the HIE tries to be everything to everyone too soon, it may never be able to establish the foundation that it can grow upon,” he said. For instance, Brull said the HIE could potentially concentrate on exchanging CCDs, lab results, and radiology results first, leaving things such as electronic referrals, home monitoring, or disease registries for a second phase. “Also, data doesn’t have to be completely interoperable from day one,” Brull added. “Maybe a portal is used to view results, instead of the results delivery being completely integrated with the EMR. Interoperability can be something that is enhanced over time, given financial constraints and needs.”

2. Understand your revenue sources. Brull argued that to achieve sustainability, a business case must be defined before the inception and implementation of any HIE. “The major part of that is understanding where the revenue sources are going to come from,” he said. “The business analysis has to show the annual revenues are sufficient to cover the operating costs.” Brull continued by saying possible sources of revenue include labs and imaging centers that want electronic connections to physicians placing orders within the HIE. “Historically, physicians have resisted the concept of paying fees for connectivity. It must be clearly understood what the participants are willing to pay, and the HIE must act as any company trying to sell a product; they must justify the coast based on the benefits received.”

3. Estimate the costs. Similar to revenue analysis, the HIE must forecast their upfront and continued operating costs the same as any for-profit business, said Brull. According to him, the “due diligence” of estimating the costs ties back to the idea of keeping it simple. “The present value of any grants plus the continued revenue sources must not exceed the present value of the costs,” he said. “High hopes of implementing a feature-rich HIE from the start can put a severe strain on the cash needed to procure the most advanced functionality.” And the more complex the system is to implement, the more expensive it will be to maintain. “Keeping the structure simple will keep the costs lower and allow for more sustainability,” Brull added. 

[See also: HIEs and stimulus funding: Don't wait; implement now!.]