WASHINGTON - A new report on health information exchange says state public-private health information exchange organizations are making progress in some areas, but the question of privacy remains a hurdle.

The report was released Monday by the American Health Information Management Association and the Office of the National Coordinator for Health Information Technology at a joint conference.

ONC chief Robert Kolodner, MD, said one barrier to HIE growth is the lack of trust across all stakeholders. Governance must include all stakeholders or “solutions are sub-optimized,” he said. Now is “a pivotal time” for building sustainable health information exchange, he added.

Preliminary findings in the report issued by AHIMA’s Foundation of Research and Education
said goals for improving quality threaten HIE development by creating competing demands among stakeholders.

There are separate and largely uncoordinated patient safety initiatives, the report said. There are also conflicts between value exchanges, data-reporting entities and “confusing, duplicative, and otherwise misaligned organizational purposes.”

“On one hand, state-level HIEs report being preoccupied with efforts to ensure implementation and sustainability of core HIE services,” authors of the report said. “On the other hand, they also relate concerns about moving into secondary use of data -- such as that for quality and performance monitoring -- without sufficient foundation and support.”