Health Information Exchanges (HIEs) continued to mature and experience real progress in 2007, while the private sector began providing a substantially larger percentage of upfront funding for community-based initiatives, according to a survey of 130 HIEs released Dec. 19 by the eHealth Initiative (eHI).
The report found that in 2007, 125 communities were moving forward with initiatives to bring together stakeholders to focus on the secure exchange of health information, with 32 HIEs now fully operational (compared to 26 in 2006). Another 68 initiatives are in the process of getting connected and 20 are still getting underway.
The 32 operational HIEs are providing a number of data exchange services, including outpatient episodes (84 percent), laboratory results (73 percent), inpatient episodes (64 percent) and radiology results (63 percent). Many are focused on offering services designed to improve population health, including disease or chronic care management (32 percent); quality improvement reporting for clinicians (29 percent) or purchaser/payers (26 percent); and providing laboratory results reporting for public health agencies (28 percent).
“It’s a very encouraging report, especially given the number of advanced-stage communities,” said Janet Marchibroda, chief executive officer at eHI. “They’re making good progress, they’re maturing, their noses are to the grindstone and we’re all learning from them. There’s just a lot of momentum going on.”
The survey also found that, for the first time since 2004, when the survey was first conducted, private hospitals have overtaken the federal government as the top provider of funding, with 53 percent of all initiatives receiving start-up monies from hospitals and 44 percent receiving federal grants. Another 43 percent received funding from state government sources.
“What it signals is the beginning of a movement across markets and that’s important because in order to change the system, we need the private sector nationally and locally to step up,” said Marchibroda. “This survey shows that they are really beginning to do that.”
But despite all of the good news, 91 percent of survey respondents said developing a sustainable business model for exchanging data remains a very difficult or moderately difficult challenge.
Marchibroda said the current reimbursement system is a disincentive for sharing health information because health plans largely reward providers by the volume of tests and procedures they complete instead of on treatment outcomes.
But she said HIEs do have opportunities to make business cases for heath data exchange on the basis of performance reporting and quality improvement, as well as drug safety and chronic care management.
“I think we can make progress in the next 12 months around some near-term business cases for clinical information to really help move this along, while also addressing the longer-term payment issues,” Marchibroda said.
From the battlefield to the home front: Managing medical data
Government Health IT presents Col. Claude Hines Jr., program manager for the Defense Health Information Management System, in this recent InSight eSeminar. Col. Hines discusses the health information technology and tactical challenges faced by the military medical community in Iraq, Afghanistan and other areas of conflict. In doing so, he describes the current information technology solutions for transferring clinical data between battlefield care givers to health care personnel at military treatment facilities worldwide.
