Q&A: Focusing on 5 state HIEs, and lessons they've learned
At HIMSS13 in New Orleans next week, two analysts from the National Opinion Research Center at the University of Chicago, otherwise known as NORC, will present observations collected during the Evaluation of State Health Information Exchange (HIE) Cooperative Agreement Program.
Prashila Dullabh, MD, director of Health IT at NORC, is a clinical informatician and also the project director for the evaluation of the state HIE cooperative agreement program for ONC. Lauren Hovey, MA, principal research analyst at NORC is also a core staff member on the same HIE program within ONC.
Dullabh and Hovey gave Government Health IT Editor Tom Sullivan a preview of their session, titled Lessons learned from HIE implementation in 5 states.
Q: What are the overarching themes prevalent among state HIEs?
A: We plan to discuss the different approaches five states are using to enable Health Information Exchange (HIE) and the experiences they are having in doing so. While states tend to have certain HIE needs and approaches shaped by their unique local markets, as a group they face similar enablers and challenges. We believe there is much to be learned from both their unique and shared experiences with HIE implementation.
Q: In your experience, what are the most common problems state HIEs are facing?
A: The State HIE Program, funded through Health Information Technology for Economic and Clinical Health (HITECH) Act, has helped states defray the initial costs in enabling HIE; however, states report that these funds cover only a portion of the cost. Furthermore, program funding will not be available in perpetuity, which means HIE approaches and options enabled by the states must meet stakeholder needs and remain affordable in the long term. Therefore, HIE sustainability remains a persistent concern.
[Related: HIE 2.0 closer than it might appear]
Engaging large health systems has also been a challenge among the states. Large health systems are often financial partners in state efforts, therefore providing value for large hospital systems to keep them engaged in state-enabled HIE is critical.
Q: Do you envision any kind of a 'killer app' for HIE? One that gets discussed, albeit vaguely, is the notion of something akin to an ATM…
A: Exchange itself has incredible power and potential to transform the healthcare system in terms of quality, efficiency, and care coordination. While our work has not identified a ‘killer app,’ there appear to be opportunities around harnessing provider interest in new care models, such as Patient-Centered Medical Homes. HIE can play an important role in helping providers manage their patients over a continuum of care.
Q: How do the states you'll discuss differ in their HIE approaches?
A: States differ primarily in their leadership and governance models and the approaches they have taken to enable HIE. Some states have opted not to establish centrally shared services while others have chosen a heavy infrastructure inclusive of a range of shared services and central clinical repository. We will also discuss the different factors that have shaped HIE in the five states.
Q: Beyond patient lookup and Direct secure messaging, what are the most common use cases for HIE?
A: Physicians are interested in a variety of immediate use cases like referrals, real-time access to Admission Discharge and Transfers (ADTs) information, and care transitions in support of accountable care organizations.
Q: If you had to describe the 'state of HIE' in one word or phrase, what would that be?
A: Developing, advancing, exciting.
Related:
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