The Office of the National Coordinator for Health Information Technology (ONC) has published research that aims to help providers and other healthcare professionals better understand several high-impact services that can sustain health information exchange organizations.

The research is meant to help those who are putting in place health information exchange (HIE) with policy, technical and business-related skills related to query-based exchange, push notification and subscription services, provider directories, master data management and consumer engagement.

[See also: HIE as a verb: ONC wants to move quickly on data exchange]

ONC is ramping up its convening activities around health information exchange. In addition to the research, ONC hosted a listening session on concerns related to rules of the road and policies between exchanging organizations.

On Jan. 29, the federal advisory Health Policy and Standards committees will conduct a joint hearing on HIE technical and business barriers, opportunities. 

Health information exchange will have a major role in meaningful use, reducing readmissions and new payment models, such as accountable care organizations. But establishing HIE is not easy, according to ONC research.

"Without these skills, there are many ways to overreach, or just as perilously, under reach, resulting in failure to maximize the long-term value of services offered through health information exchange," John Rancourt, program analyst at ONC, wrote in a post on the Health IT Buzz blog. ONC contracted with Audacious Inquiry, a health information technology services company, to support the state HIE grantees with research as they continue to build their health information exchange.

[See also: HIE as platform for innovation]

Among the findings explained in the reports:

1. Query-based exchange. A large monthly average number of patient record queries indicates a successful HIE. Hiring and retaining a chief executive who is responsible for strategic vision, sales, marketing, daily operation and complex technical implementation projects, and at a modest salary, is challenging.

2. HIE-driven notification and subscription services. Push messages, which are a relatively simple technology, can advance care coordination for meaningful use, reducing readmissions and for new payment models, such as accountable care organizations. For example, the Indiana HIE (IHIE) sent hospital admission alerts and discharge summaries to primary care providers. IHIE will test notifying managed care organization case managers when their members are admitted to a hospital or visit emergency department.

3. Provider directory solutions. These electronic white pages enable one provider to look up contact information for another provider. In the future, provider directories will have uses for health insurance exchanges and state licensing boards and may help HIEs attain sustainability.

4. Master data management. Master data management is how two pieces of electronic health information are appropriately merged or kept separate, which is difficult when there are varying levels of data quality on patient identities. Tools can help HIEs accurately capture and coordinate a patient’s identity and can be used for more advanced data analytics associated with new payment models or patient-centered medical homes.

5. Consumer engagement and consumer-mediated exchange. The research explains considerations in identity proofing, identity authentication and access, and several case studies, including from UnitedHealth Group, Aetna and Microsoft HealthVault.