The National eHealth Collaborative's Health Information Exchange Learning Network has recommendations for tackling some of the most challenging HIE issues.
The tips, compiled in a series of whitepapers titled "Following the NeHC HIE Roadmap: Four Routes to Success," come after five months of collaborative work by a group of more than 450 stakeholders.
[See also: NeHC continues engagement push]
The HIE Learning Network whitepapers document the workgroup’s process, landscape, research analysis, conclusions, recommendations and multiple case study examples, officials say, and seek to accelerate the widespread deployment of interoperable HIE and the first significant outcomes of the HIE Learning Network.
Officials say NeHC's HIE Roadmap lays out:
- A formula for achieving multi-stakeholder HIE financial sustainability, including a projection that $7.5 million in annual revenue is needed to maintain long-term financial stability
- A critique of the current interoperability standards and certification ecosystem, with a bold proposal for measuring progress
- Two comprehensive strategies for addressing community level HIE needs, including identification of multiple high value/low cost services
- Critical success factors for HIE initiatives positioning for success in a value-based environment
- Eleven extended case studies that bring the recommendations to life
“Health information exchange is difficult," said NeHC CEO Kate Berry. "Our HIE Learning Network workgroups have done a fantastic job of coming up with best practices and recommended strategies to overcome some of the toughest HIE challenges."
And there are plenty of challenges, of course. One of the biggest, of course, is the sustainability of public exchanges, which, as John Hoyt, executive vice president of HIMSS analytics/directory/analytics" target="_blank" class="directory-item-link">analytics told Healthcare IT News, are "going to have to have some sort of funding mechanism" to stay afloat. "Everybody wonders what's going to happen when the feds say, 'OK, we've given you enough money for enough years. You're on your own.'"
Different HIE Learning Network workgroups studied specific challenges related to HIE and worked to develop recommendations to address them and accelerate progress. Each approached the issues from a different perspective, but a number of themes were heard across multiple workgroup discussions, say NeHC officials. These include:
- Realizing that consistent implementation of interoperability standards is fundamental to achieving widespread HIE;
- Leveraging lightweight and flexible technologies and readily available data sets will jumpstart exchange and build momentum on which to expand
- Achieving early value builds trust among participants and will help drive growth; this requires open, transparent governance so competitors will share information
- Implementing high value bundles of HIE services will help drive adoption and position for sustainability
- Reaching critical mass of connected providers and data sources is key to a compelling value proposition
- Understanding and responding to your customers’ needs on an ongoing basis such that you offer products and services that solve their problems will help ensure they are willing to pay for those products and service
HIE organizations that provide business intelligence and data analytics to support actionable, effective clinical decision making to improve quality and cost outcomes can play a powerful role as healthcare transitions to pay-for-value, say NeHC officials.
Among those groups contributing to "Following the NeHC HIE Roadmap" are Chesapeake Regional Information Systems for Our Patients (CRISP); Coastal Connect Health Information Exchange; Delaware Health Information Network; HEALTHeLINK; HealthInfoNet; Inland Northwest Health Services; Iowa Health System; Michigan Health Connect; Northern New England Accountable Care Collaborative; Quality Health Network; Surescripts; Wisconsin Health Information Exchange
Shaun Alfreds, chief operating officer of Maine's HealthInfoNet, was a contributor to a joint case study with the Northern New England Accountable Care Collaborative for the NeHC HIE Learning Network workgroup on HIE Functions to Support New Payment and Delivery Models.
“These reports are a great step towards finding solutions to the most trying HIE problems we are all facing every day," said Alfreds. "HIEs cannot simply act within a vacuum and none of us has it all quite figured out yet. I know we will apply some of the HIE Learning Network workgroups’ recommendations here at HealthInfoNet in Maine. We greatly appreciate the opportunity to share our story and learn from our colleagues."
The roadmap comes at the end of a very busy year for HIE development nationwide.
"Where we are today, we're seeing a lot of activity – whether from the federal or state level – that has helped spearhead over the last couple of years, more energy around health information exchange organizations," says Pam Matthews, senior director at HIMSS. "In another five years, we'll still see this as a transition."
In the meantime, strategies are "evolving as the industry learns more about health information exchange organizations," she says.
"We are seeing states, where some are not as aggressive, we are seeing some being very aggressive in establishing a state-level HIE," says Matthews. "We also are seeing some states that are using Direct, and are looking at other options instead of actually setting up a full-fledged state level exchange.
"Various flavors that are materializing," she says. "Each state has its geographic market drivers, as well as political drivers."
"Following the NeHC HIE Roadmap: Four Routes to Success" is available for purchase on the NeHC website.