Privacy and security, sustainability and funding were identified as the top three pain points in health information exchange (HIE), according to the results of the National eHealth Collaborative's (NeHC) first ever Stakeholder Survey.

NeHC established this survey initiative in December 2010 to encourage stakeholders across a wide range of specialties to contribute their suggestions on major concerns in health information exchange.

[See also: StateNet Workgroups Develop Guiding Principles for HIEs, RECs]

"From the perspective of a collaboration among healthcare organizations that are facing many of the barriers identified in this survey, I believe that NeHC is making a substantial contribution by bringing these issues to light and encouraging the key sectors in the health IT marketplace to focus on producing collaborative solutions. This survey is just the beginning of an invaluable dialogue about what we need to do to achieve a sustainable and robust nationwide health information exchange," said Holt Anderson, executive director of the North Carolina Healthcare Information and Communications Alliance (NCHICA) and member of the NeHC board of directors.

Among the questions answered in the survey, respondent data strongly suggested that a number of concerns and opinions are shared widely across the stakeholder spectrum:

• The issues that over 80 percent of stakeholders agreed were most likely to potentially derail health information exchange were identified as:
• Privacy and Security: 46 percent
• Sustainability: 21 percent
• Funding: 15 percent

[See also: Slideshow: Provider perceptions of HIE]

More than 60 percent of the issues in HIE causing the greatest concern were in three areas:

• Privacy and Security: 30 percent
• Adoption and Use: 16 percent
• Sustainability: 14 percent

More than 60 percent of stakeholders indicated that the most-requested issues on which they would like to receive regular updates due to the constantly-changing environment in HIE are:

• Governance: 23 percent
• Privacy and Security: 19 percent
• Legislative Barriers and Regulations: 19 percent

The solutions that 60 percent of stakeholders indicated that they were most willing to collaborate on are:

• Adoption and Use: 21 percent
• Privacy and Security: 20 percent
• Governance: 19 percent

NeHC's call for comment elicited responses from a fairly balanced distribution of stakeholder interests. Participants spanned the private and public sectors, representing the following stakeholder areas:

• Healthcare Providers: 21.8 percent
• Government: 16.4 percent
• Consultants: 13.9 percent
• Other (Consumers/Advocacy, Administrative, Population Health, Clinical Research, etc.): 12.1 percent
• Health Information Organization: 10.9 percent
• Vendor: 10.3 percent

"Through this survey, NeHC is playing an important role in getting all stakeholders in the health information exchange effort on the same page to focus on common problems and common goals. Talking about these results will help to encourage stakeholders from across the health IT community to share solutions and best practices with one another so that we can reach our national goals for health IT," said Michael Lardiere, LCSW, director, Health Information Technology and senior Aadvisor, Behavioral Health for the National Association of Community Health Centers (NACHC) and NeHC board member.

NeHC will use the results and stakeholder feedback to inform the further development of its 2011 Stakeholder Forums and NHIN University stakeholder education programs.

"NeHC looks forward to bringing stakeholders together in ways that can help our community reach consensus on solutions to address these barriers," said NeHC CEO Kate Berry.