While the health information exchange market remains in a state of “persistent unpredictability,” there are pockets of EHR data interoperability around the U.S. But the last year saw a drop in regional connectivity.

That’s according to Black Book Research’s HIE stakeholder survey, which examines both the current state of the HIE market and users favorite HIE technology vendors.

“A short list of enterprise HIE vendors have effectively established operative exchanges across organizational siloes to benefit patients, providers, agencies and payers,” said Doug Brown, managing partner of Black Book Research in a statement. “Those vendors are justifiably earning the lion’s share of 2015 initiatives and stymied HIE developers are reconsidering their positions.”

The vendors
Black Book polled users of 224 operations – public and private exchanges – and here are the vendors ranking first in their categories:

Cerner: EHR/HIT-based HIE
Orion Health: Government Payer and Commercial Insurer Centric HIEs
Aetna Medicity: Core Private Enterprise HIE Solutions
Intersystems: Core Public HIEs Systems

“Other vendors that scored well in specific key HIE performance indicators were: Alere Wellogic, Availity, Caradigm, CTG, dbMotion Allscripts, Epic Systems, Greenway, GSI Healthcare, HealthUnity, ICA, Infor (Lawson), McKesson RelayHealth, Medecision, Optuminsight, QSI Mirth NextGen, Sandlot, and Siemens,” according to Black Book. 

HIEs (the noun)
When it comes to health information exchanges, Black Book found a rather uncertain future.

In a separate polling of more than 5,000 people — spanning hospital executives, doctors, patients, payers and vendors — Black Book determined that as many as 90 percent of hospitals and 94 percent of independent physicians are “retreating from complex HIE endeavors” because the business models are not sustainable and it is not yet clear how health insurers will figure into the costs of data sharing.

"Payers are determining how they can best manage the HIE ecosystem by gaining access to the clinical data of covered members," Brown said. “Outside of their garden walled EHR networks, providers are dropping HIE as a priority, as evidenced by a 5 percent drop in regional connectivity from last year.”

A big EHR switch?
What with nearly 90 percent of urban hospitals and practices using a functional EHR, one of the most surprising findings in Black Book’s research is that as many as 94 percent of agencies, payers, providers, and patients remain “meaningfully unconnected” in the first quarter of 2015, the firm said.

“As risk sharing increases, so will the demand for meaningful, robust data sharing between providers and payers regardless of the EHR employed. “ Brown added. “If the interfaces for interoperability between the HIE and stakeholders is too difficult to evaluate and analyze risk, the more likely we will see another round of EHR replacements.”

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