“Once the cost of increasing information flows has come down, the value has increased, then information will flow,” Mostashari said, adding that he expects it will begin on a first name-basis with patients sharing health data among people they know and trust. “That is happening. We see that growing.”

In describing HIE 2.0, Tripathi echoed both of those statements, saying that the new era of exchange is more verb than noun because “transactions may or may not be mediated by some kind of organization that calls itself an HIE,” rather, the exchange of health records is beginning to be more demand-driven by patients, and healthcare organizations are trying to meet those immediate interoperability needs with whatever tools are available and do so within existing business, legal, and technical restraints.

The presiding notion is no longer to wait for the legislature to pass something that enables large-scale nationwide exchange and, instead, now it’s “let’s try to fit whatever we do within the current paradigm that we have and sometimes that means the technology gets out ahead of policy,” Tripathi added. 

Indeed, the next-generation array of health IT services for HIXNY includes providing access to a comprehensive patient health record, automating results delivery and event notification, and further unlocking the HIE’s value through analytics for population health management, HIXNY CEO McKinney (pictured at left) explained, pointing to a potential example in which a chronic-condition patient receives electronic notifications to take actions that maintain or improve health.

“This future is closer than many may think,” McKinney said.

At Florida HIE, HIXNY, and OHA, the supplantation ostensibly mimics the fashion in which the Web evolved into Web 2.0 — a reformation inevitable for HIE as today’s tech-savvier government officials, cadre of physicians, clinicians and medical students, and healthcare consumers eclipse the aging crop of doctors for whom even e-mail with patients is an evil best eluded with career’s end in sight. 

“It’s almost impossible to think about a younger generation clinician walking into an MS-DOS environment while streaming Spotify on an Android device,” Tripathi chuckled. “It’s just culturally not going to work.”