By definition, health information exchanges (HIEs) allow for clinicians and patients to have secure access to patient data across disparate healthcare systems.
HIEs still have various obstacles, one being that most state HIEs were formed with grants and those funding streams have started to run their course. We have also seen the HIE vendor market shift from a ‘one throat to choke’ model to a ‘best of breed approach,’ with many HIEs now on their second vendor. In addition, vendors are consolidating in the market with payers or other data warehouse offerings. The moral of the story is that with the shift from fee-for-service to value-based care and the sunset of Meaningful Use, HIEs must quickly establish themselves as self-sustaining organizations with real business value. Vendors must also be able to deliver more than just ‘the pipes’ in a timely, cost effective, and standards-based way, so HIEs may continue to exist and benefit the consumer.
In an interesting HIMSS survey, 14 HIEs across the country found that a few things played into both sustainability and driving value into the HIE. One was adoption, meaning that reaching critical mass (more than 50% of providers or of the hospital connected to/using the HIE) is typically correlated to the success rate of the HIE. My experience in the industry is that adoption must be supported by a vendor who can deliver timely and affordable interfaces while also supporting a workflow back into the EMR. Simply adding another clinical portal does not drive adoption. Many vendors claim they can deliver standards-based interfaces and parse CDAs promptly, only to fall short. A truly seamless workflow directly into the EMR with only the information you need on the patient is a golden standard we all wish to obtain, and it does exist.
Value correlates to sustainability, and this point is backed up by the same HIMSS survey, which explains that ‘the plumbing’ alone, is not enough to drive value. Three of the areas of functionality that were frequently requested of HIEs were:
- Image Exchange
- Clinical Quality Measure Support (CQMS)
It is no shocker to see the last two, reporting/analytics and CQMS with the rise of value-based care. The purpose of HIE is to drive efficiencies within a community (plumbing), so it would make sense for the community to leverage analytics at scale within an HIE.
HIEs need to be able to present actionable insights at the point of care, which often requires more than just parsed clinical data from a clinical data repository, in a web-based portal. Having a holistic view of patient data results in better coordinated care, improved quality, and reduced costs while feeding into analytics and reporting tools to support quality coverage for a population. Lightbeam knew that the healthcare industry needed a solution that would enable communities to exchange data from disparate systems, allowing providers to have the most comprehensive, up-to-date patient information, pushed to them with an integrated patient’s record. It is this reason that Lightbeam Health Solutions extended its end-to-end population health platform to include a robust health information exchange platform. It made perfect sense with over five years in the population health management space, 750 live interfaces, $300 million savings generated by our customers, and 60 HIEs stood up across the globe for Lightbeam Health Solutions to take a next generation HIE to the market.
HIE Sustainability Models Survey Results and Analysis. HIMSS, 2016, www.himss.org/hie-sustainability-models-survey-results-and-analysis.