Kate Berry for health data exchange

By Bernie Monegain
02:56 PM

Kate Berry, CEO of the National eHealth Collaborative, which recently released a roadmap for establishing and operating successful health information exchanges (see page XX), figures she caught the healthcare bug from her family. Her parents met in a hospital. Her mother, a dietician, ran the cafeteria and later did public health research. At the time, her father was studying for his doctorate in biochemistry. Her sister is a physical therapist.

“I think healthcare is a field where it’s easy to be inspired about how it can impact potentially everyone’s life,” she says.

Along the way, Berry found mentors who inspired her: Dr. Bernadine Healy, “a very strong visionary, principled leader,” is one. Healy died in August 2011, but she remains an inspiration to Berry. Jerry McManus, president of consulting firm McManus Associates is another influence as is Kevin Hutchinson, founder of Surescripts, who now serves as CEO of the NeHc board. With each of them Berry honed her own leadership skills. She credits McManus with teaching her how to think strategically, how to build relationships, how to manage projects and teams, and how to solve problems. She calls Hutchinson, “a great strategic and business mind.”

The leadership skills her mentors helped form come in handy as Berry helps to lead the charge to an interoperable healthcare system.

Q. What is most compelling about your roll at NeHC?

A. The reason I came to National eHealth Collaborative is because I really saw it as a very unique platform for collaboration. The caliber of leadership on the board is truly outstanding. The organization’s very close relationship with the Office of the National Coordinator is really an important part of what makes us successful. By virtue of being a public-private partnership that has that close relationship with the government, and yet the independence of the private sector, it’s really a unique platform for collaboration. One of the things that is really cool about NeHC is our vast network of stakeholders that are engaged with us. We have this ability to find the people who are ahead of the game and then leverage that experience to help others by having the ability to disseminate and to convene and to share lessons learned. We have the ability to help accelerate what’s going on.

Q. What about the challenges?

A. It’s a big challenge to stay focused. There’s an incentive to try to do everything because there’s so much to do, and I think it’s really important that we keep our focus on the thing where we can have the greatest impact. We definitely try to stay very, very focused in three areas. That is health information exchange, patient engagement, and NeHC University – our education programs. We try not to get too off those three areas. We are very focused on managing our resources so that we can have an impact in those areas where we are best positioned to make a difference.

Q. How did the HIE Roadmap come about?

A. We do a lot of work in the whole arena of health information exchange – everything from supporting the formation of the nationwide health information exchange to studying some of the leading health information exchange organizations and profiling them as well as engaging with some of the more emerging health information exchange initiatives. Through all of that work, it became pretty clear to us that there remained quite a bit of confusion in the marketplace about how to proceed in health information exchange. Even those that are leading the way, they know that the models and the approaches and the services that are offered are going to continue to evolve, and even the business models for that matter. Those that are in the earlier stages are not really sure of how to proceed. There’s a lot of confusion about what the government’s doing.

There’s a lot of confusion about what works in terms of business models, what types of information should be exchanged first, etc..etc..

Through all our programs, we also get a window into what stakeholders out in the field are struggling with.

Q. What are the top three barriers to health information exchange?

A. No.1, people usually say, is funding and the sustainability model. Another challenge has to do with the interoperability standards. Even though there are industry standards out there for exchanging information, depending on the level of specificity of those standards, there may be variation in how those standards are implemented. The last one is the issue of there’s lots of electronic health records out there. And so you’re getting interoperability and exchange to happen among all those different electronic health records that practices are now adopting. It’s challenging because it’s costly to do the interfaces among them.

Privacy and security is definitely on the list as well.

Q. Are there models for sustainability that might be used for most exchanges?

A. I think there’s going to be multiple business models, and those models are going to evolve over time. What we’ve learned from the leaders is that typically everyone who benefits has to pay something. Typically they don’t like transaction fees because that essentially means that you pay every time you use it. Most HIE organizations figure if it’s going to cost me more to use the data, they’ll be de-incentivized to use the data.

People are looking at a subscription fee as opposed to transaction fee. They also say you can’t rely on government funding or grant funding to cover your operations. Those organizations that have sustainable models have a very business-minded approach. They only offer services that their customers are going to pay for because they get value.

Q. How long might it be before we as a nation are used to the exchange of health information almost like we’re used to using an ATM?

A. That’s really a tough question. People have been working on this for decades. Despite all that work and investment, we really don’t have a lot of health information exchange happening today. There are pockets of success, but it’s not very widespread. I think in the next five years there’s going to be a lot of progress. Now I may be a little naïve in thinking that. There are a number of factors at play. Health information exchange becomes much more important in Stage 2 of meaningful use, and I think that’s going to be a major driver.”