Vermont’s health information exchange has big financial and administrative problems, and a recent review by Kentucky-based technology consulting firm HealthTech Solutions concluded that most exchange users had lost confidence in the organization.

The HIE, which is is operated by Vermont Information Technology Leaders (VITL), has received $44.3 million in state and federal funding since its launch in 2005. 

The concerning review comes at a time when many state HIEs are trying to determine the best way toward financial sustainability because they are going to become critical to the Office of the National Coordinator for Health IT’s charge to implement the 21st Century Cures Act. 

[Also: What's next for health information exchanges?]

Vermont HIE’s administrators are not ready to give up and, instead, said they are developing a multi-year plan to bolster the exchange. HealthTech survey results, in fact, showed stakeholders consider it critical for Vermont to continue operating the entity.

But there are challenges ahead. The survey also revealed the HIE’s current structure and governance is not meeting stakeholder and state needs. In response to a survey question, only 9 percent of respondents agreed the state has provided guidance and planning for the HIE. 

Other responses said stakeholders believed the exchange could be fixed with better technology and improved governance and organizational structure. The HIE, which is is operated by Vermont Information Technology Leaders (VITL), has received $44.3 million in state and federal funding since its launch in 2005.

The exchange is critical for Vermonters who rely on the HIE to provide data for Accountable Care Organizations as well as for policymakers to measure effectiveness and impact on costs.

There are models for operating successful HIEs. Colorado, Delaware, Maine, Maryland, Michigan, Nebraska and Utah are oft-lauded success stories.  

For its assessment of the Vermont HIE, HealthTech Solutions conducted interviews with 89 Vermont stakeholders, 60 individuals, eight focus groups and a technical expert panel, among stakeholders.

[Editor's note: A previous version of this article mis-identified some HIEs as being state run when they are not. That has been corrected.] 

Twitter: @Bernie_HITN
Email the writer: bernie.monegain@himssmedia.com