Report: HIEs failing at true interoperability

By Mike Miliard
11:04 AM
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While some $560 million in federal health information exchange funding may soon run dry, changing reimbursement models mean market-driven growth will continue, says a new report on HIEs from Chilmark Research.

Profiling 22 HIE vendors, the study, "2012 HIE Market Report: Analysis and Trends," shows a market that's evolving, making the shift toward serving healthcare organizations of all sizes as they position themselves for payment reform, its authors say.

[Q&A: RWJF's Michael Painter, MD, on MU stage 2's impact on public and population health.]
 
Increasing HIE technology adoption is spurred by two factors, say researchers. First is the need to meet proposed Stage 2 meaningful use requirements, which put a far greater emphasis on data exchange. More crucially, big changes on the horizon with regard to reimbursement means healthcare organizations are implementing HIE technology to support community-wide care coordination.
 
"As federal incentives drive the adoption of electronic health record (EHR) technology in the U.S., we will quickly move into the post-EHR era where the value of patient data is not what is locked in an EHR data silo, but the cumulative patient data that resides in the community HIE network,"  said John Moore, founder and managing partner of Chilmark Research.
 
Vendors are taking note. Chilmark researchers point out that, since publishing its first HIE report in January 2011, one third of the firms profiled in that report have been acquired, merged or have exited the market. Nonetheless, the 2012 report profiles even more vendors, all of them seeking to capitalize on the double-digit growth exhibited by the HIE market in recent years.
 
"Last year, we commented on an increasingly crowded and competitive market," said Moore. "Today's market is more competitive than ever, but just as immature as it was last year."
 
Be they public networks or enterprise set-ups, most HIEs nowadays exchange fairly simple data sets, such as lab results and patient summaries – falling far short, researchers say, of the vision of an integrated record that can facilitate care as patients move between care providers and settings.

Until EHR vendors incorporate a shared set of standards, HIEs will remain in a state of stunted development, said Moore: "Across the board, legacy systems fail to support true interoperability, and vendors are doing little to remedy this situation."

[See also: Interoperability failure causes headaches for Maine Medicaid.]
 
That said, reporting and analytics capabilities have become a top priority for most HIE developers, the Chilmark report finds. That's in response to the Centers for Medicare & Medicaid Services' plans with regard to outcomes-based reimbursement – and the market need for more accurate reporting that goes along with that. Every vendor profiled in the report offers some form of analytics and reporting capabilities, but most offerings remain limited, say researchers.

At present, that's not a big deal, as there's still a relative lack of computable data originating from EHRs and flowing through the HIE network, they argue. But as standards come into greater use, the need for more robust analytical tools will accelerate.