Public-private partnerships to develop health information exchanges? Forget about it.
For-profit, businesslike HIEs are the way to go in the current environment, according to a company president who says the free enterprise model can deliver results better, faster and cheaper.
“Business-driven health information exchanges are emerging as a rapid-deployment, cost-effective, sustainable alternative to RHIOs,” Dr. Elliott Menschik, president of HxTechnologies, told a Capitol Hill audience today.
Working with radiologists, his company is developing a for-profit HIE that will deliver radiology images to doctors in Philadelphia. By focusing on existing business relationships and using industry-standard technology, the company can save its customers time and money, Menschik said.
In New Jersey, HxTechnologies is building the New Jersey Health Information Exchange for a client, the AmeriHealth subsidiary of Independence Blue Cross.
The Philadelphia project began with grant funding from the National Institutes of Health, but that funding ran out last year. Now Menschik is in discussions with two large insurers in the Philadelphia area, Independence Blue Cross and Aetna, about sponsoring the project.
It would make business sense for health plans to sponsor such projects, he said, because a radiological image exchange could help them hold down the costs of imaging, which are rising about 20 percent a year. In many cases, the patients have previous images that would be helpful to a radiologist trying to interpret a new x-ray, MRI or CAT scan, but the earlier images are not at the same institution.
By obtaining earlier images, the doctors may be able to avoid subjecting the patient to additional and more expensive diagnostic procedures, Menschik said. That not only holds down costs, but also protects the patient from additional exposure to radiation.
Speaking to the Capitol Hill Steering Committee on Telehealth and Healthcare Informatics, he said government does have a role in health information exchange. First, he said, the Centers for Medicare and Medicaid Services should do as private insurers are doing and invest in HIE services to reduce redundancy of health care services such as radiology and laboratory tests.
Because Medicare beneficiaries get radiological services at two or three times the rate of younger people, such a move would save CMS so much money that “it could probably fund the [Nationwide Health Information Network] all by itself,” Menschik quipped.
In addition, the federal government should use its procurement leverage to accelerate adoption of the standards embraced by the Health IT Standards Panel and the private Integrating the Healthcare Enterprise (IHE) project, Menschik said. And the federal government should ensure that a patient can obtain his or her online health records.
But the current federal push for what he called “altruism-driven” HIE is not getting results because “the lowest common denominator approach paralyzes participants,” he said. The need to achieve consensus on every issue slows the process to a crawl, and fear of antagonizing anyone means that the actions with the greatest potential impact are avoided. The projects are dependent on grants that eventually end, leaving the HIE without enough funds.
Later, he told a reporter that substantial amounts of federal funding for HIEs would be a good alternative to the business-driven efforts he is advocating. But that kind of financial support does not seem likely to be forthcoming, Menschik added.
Government Health IT presents Rick Friedman, director of the division of state systems for the Center for Medicaid and State Operations with the U.S. Department of Health and Human Services, in this recent eSeminar regarding how the federal Centers of Medicare and Medicaid Services is partnering with state Medicaid and health and human services officials to bring Medicaid into the digital age. Paul McCloskey, Government Health IT editor, moderates.
