Health Information Exchanges Need to Alter Their Course, Report Says

State Health Information Exchanges are barely out of the starting gate but might already need to change course, according to a new report from the HIMSS State Advisory Roundtable.

The report, "States Will Transform Healthcare through Health IT and HIE Organizations," asserts that as the industry evolves "the sustainability model for HIEs also must change, and concentrate more on coordination facilitation, instead of merely information exchange.” The change in direction could help HIEs thrive as the healthcare industry moves from a fee-for-service to a value-based care model.

Indeed, there are big questions about many HIEs' sustainability under the current information exchange model.

"With few exceptions, such as Rhode Island and Vermont, the state-level HIE business model is almost completely void of private investment, leveraging mostly state and federal funds for development and implementation activities," according to the report. "Most models that have found success to date are based on driving efficiencies to providers in a fee-for-service model."

To succeed under new reimbursement models, however, HIEs need to expand their scope.

"This will likely come in the form of leveraging HIEs for care coordination, tele-health visits and quality and payment analytics. Therefore, the business of state HIEs will likely need to shift from 'facilitator of sharing' to 'data aggregator and analyzer' in order to build a sustainable business plan. The challenge will be to provide a basis for comparison across private providers," the report states.

In a blog post on the Government Health IT website, Vermont Gov. Jim Douglas and former Wyoming Gov. Jim Geringer, both members of the HIMSS roundtable, offered the following advice:

  • States should leverage their HIEs and other IT infrastructure in new and innovative ways, such as closer partnerships among state governmental entities, regional extension centers, and professional trade associations.
  • Health IT "transcends political lines" and should be a top legislative priority, regardless of which party is in power, to maintain its forward momentum.
  • States should "facilitate, engage and educate patients and consumers with the delivery of their healthcare services and promote overall increase in health literacy."
  • Health IT should be foundational to healthcare reform.
  • As that reform drives the shift from fee-for-service to pay-for-quality models, state-level HIEs--to remain sustainable--will need to change their business model, from health information exchange to healthcare coordination facilitation.
  • Better coordination is needed between and among federal and state health agencies to make sure state-level HIEs are aligned with funding sources to ensure success.