Public and private health information exchanges (HIE) have one model for collaboration in Ohio, where the state-designated HIE functions as a nonprofit that aims to build its own networks while offering services that complement private health information sharing at various levels, Dan Paoletti, CEO of the Ohio Health Information Partnership said during a HIMSS Government Health IT Virtual Briefing on Wednesday.

Created as an independent nonprofit in 2009 through a partnership with the state government, the Ohio Hospital Association and others, the Ohio Health Information Partnership operates an HIE, under the brand name CliniSync, and serves as the regional health extension center in most of Ohio’s counties.

The organization has been working with various urban and rural providers, helping large health systems with the coordination of information sharing and advising many providers on Meaningful Use, while expanding its own network, Paoletti said.

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The Ohio Health Information Partnership’s idea is for public HIEs like CliniSync and private HIEs to compliment each other, for instance in areas where the public HIE can help link various private HIEs, Paoletti added. And the public HIE has a niche in being able to create an environment where stakeholders can work toward common goals.

Through the organization’s extension centers, they’re working with more than 6,000 Ohio providers to adopt electronic health records through the Meaningful Use program, and there’s about 50 hospitals and 500 providers in the process of coming onto the HIE, Paoletti said.

One of the biggest needs the public HIE can help fill for private HIEs, Paoletti explained, is offering “ease of entrance, the ability of providers to participate in the beginning.” The Ohio Health Partnership has focused its network especially in rural Ohio, where providers and regional health systems might not have the same capacity of hospitals as in Cleveland or Cincinnati.

Paoletti, former vice president of the Ohio Hospital Association, said his experience has led him to conclude that both private and public HIEs are probably needed across states and regions to support health systems technological advances and health information exchange. (In Ohio, there’s another public HIE, HealthBridge Ohio, serving mostly greater Cincinnati.)

In the role of a nonprofit and vehicle for collaboration, Paoletti said, there are a few common market scenarios that the partnership has found itself well suited to help.

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For an independent hospital and small healthcare system competing in an urban market with a recently implemented EHR system, the next step could likely be finding and implementing a strategy for connections, especially in the area of care transition and coordination, like for hospitals participating in models such as accountable care organizations or patient-centered medical homes.

CliniSync, as a public HIE, can walk the health system's leaders through different business cases and different Meaningful Use options. “We can give them a good idea of how much resources it’s going to take,” Paoletti said, “and we can layout a plan and a timeline for them.”

For several health plans participating in Ohio’s Medicaid managed care programs (starting next year), CliniSync is aiming to provide its HIE as a way to track ER visits and follow-up care. And large urban health systems that are investing in their own HIE systems may want to be able to link outside of their network, which can be costly, Paoletti said. Here the public HIE can offer connections between health systems as a service.

Indeed, there's a natural role for public HIEs in these scenarios, Paoletti said, and, in turn, without having multiple business ventures, CliniSync and other public HIEs would have a hard time becoming financially sustainable.