The meaningful use Stage 2 standards are expected to reduce some of the confusion associated with health information exchange.
Some of that confusion, including questions over a public or private exchange model, consent management, structured data use and challenges to acceptance by physician, was played out at an overflow Monday session, "HIE: Reality & Future," at the 2014 HIMSS Annual Conference & Exhibition.
Vendors have had their own proprietary approaches in many cases because they want everyone to stay in their family of products, said session speaker Kenneth Kleinberg, managing director, The Advisory Board Company.
"The government has basically said that vendors have to play in the sandbox together and at least exchange at this level. And then we'll ratchet it up even higher in Stage 3. I think it will make a huge difference," he said.
Health information exchange is moving towards a document exchange model and use cases have been established for what needs to go from one type of provider to another provider.
"The transport mechanisms, be it Direct protocols or email or others, are easier to deal with than what we are going to exchange. The meaningful use Stage 2 criteria really upped the standard for how organizations can communicate, and they prevent vendors from staying in their own closed silos," he said.
Vendors will have to meet those minimum standards, although they can do more to provide choices for providers over and above that.
HIEs will increasingly be used to support data repositories, registries, data warehouses and analytics, including population health.
Many exchanges, however, are still at the early stage of operations. At the core, many HIEs are small businesses, and, like in other industries, carry similar risks around sustainability, he said.
The health information exchange environment is like a "a patchwork quilt here filled with different stitches, but over time we're going to cover the spaces and gaps. Exchange standards are the future here, such as the idea of a Consolidated CDA and documents that everyone agrees upon, even down to the terminology level of individual fields. But it's a long journey," Kleinberg said.