WASHINGTON – A new study cites social capital, or stakeholder goodwill, as one of the key components to self-sustaining health information exchanges.

The eHealth Initiative Foundation recently released a study on common themes of successful health information exchanges (HIEs) and how they become self-sustaining. The findings were culled from four years of working with HIEs.

The report, Health Information Exchange: From Start Up to Sustainability, identified factors that help create value in HIEs:

• Social capital, or stakeholder goodwill

• Human capital

• HIE functionality, which may evolve over time from being purely transactional to creating other value propositions.

• Heightened value when non-provider data users can positively impact the quality of healthcare.

The study found broad agreement that while national standards and policies are being created, the industry cannot build a nationwide health information network from the top down.

“It has to be from the ground up,” said Janet Marchibroda, president and CEO of the eHealth Initiative. “You need local efforts. I think there is broad recognition that in order to move fast, we need to avoid a one-size-fits all.”

With markets across the country so diverse – catering to a variety of needs, she said social capital must happen at the local level.

Marchibroda noted that more than 200 social capital organizations comprising employers, hospitals and physicians already exist.

“Social capital development is well under way,” she said. The issue is how to get the social capital networks to implement HIEs and then determine how to pay for HIEs in the long run.

“Our leaders – the social capital builders – are going to need to take the next step and use their business acumen to develop services that derive value,” she said.

To be successful, HIEs must graduate from grant funding to operational revenue, said Marchibroda, who emphasized the importance of “infomediaries,” which already are delivering operational value for HIEs. “Information exchange has a large impact on direct care delivery,” she said. “You’re bringing information to the doctor at the point of care.”

Infomediaries have the potential to make good on the vision of the quality and safety movement – improving the health of populations. Claims data is used to assess the health of populations. Now clinical data can be brought to the fold.

“Through infomediaries, we open up the opportunity to get more timely and accurate information about outcomes and effective delivery to understand adverse events such as public health outbreaks,” she said.

Marchibroda takes into account the privacy concerns associated with sharing data with other groups (pharmaceutical and medical device/technology manufacturers, payers and third-party application vendors, in particular). There are no privacy concerns, she said, “so long as we build in effective principles and policies for data access and use, and we get consensus – with consumers at the table – on a set of principles that are respectful of patient privacy and confidentiality.”