Health Information Exchanges Face 'Growing Pains'

A new report based on a survey of health information exchanges highlights some of the challenges and other concerns that might temper growth.

Many in the medical world are excited about the promise of health information exchanges that will link physicians with hospitals for better transfer of patient data. 

But a new report based on a survey of health information exchanges - called “The eHI 2011 Report on Health Information Exchange: The Changing Landscape” - highlights some of the challenges and other concerns that might temper the growth of exchanges.

According to the survey, conducted by the Washington, D.C.-based nonprofit organization The eHealth Initiative, there are growing pains that hundreds of HIE initiatives are experiencing today as they grapple with competing timelines to meet federal requirements, complex systems integration, and the uncertain future of ACOs.

“Some exchanges have solved their technical issues and are offering more advanced services, such as analytics, quality reporting, wellness programs, and education to providers and hospitals. As a result, they are in a much stronger position than those that have not expanded services,” said Jennifer Covich Bordenick, CEO, in a press statement. “HIE initiatives that cannot adapt quickly may not last long in a transformed healthcare system.”

According to the survey, there has been a net growth of 9 percent in the number of HIE initiatives, which totaled 255 in 2011. At least 10 HIE initiatives have closed or consolidated, and 46 new initiatives responded to the survey. Twenty-four HIE initiatives report that they have sustainable business models, up from 18 in 2010.

For the most part, stakeholders in charge of HIEs are optimistic; much of the work being done to boost exchanges is around the development of complex privacy controls for patients. It’s also interesting to note that one quarter of survey respondents said they will support an ACO. Additionally, the majority of advanced initiatives (85) are offering at least one service that supports CMS’ “meaningful use” requirements.

How HIEs will affect practices depends on a variety of factors (such as how far along a practice’s state is in building an HIE).

In Wisconsin, for example, healthcare officials applied a $9.4 million federal grant to build a network of networks that leverages the state’s extensive HIEs, Physicians Practice contributor Ken Terry reported. Overall, about 70 percent of the state's physicians participate in local exchanges.

“The number of [HIE] initiatives offering services that improve patient care has increased in 2011,” Covich Bordenick said. “As more HIE initiatives provide services such as e-prescribing, alerts to providers on drug interactions, clinical decision support, and medication reconciliation, the quality of care for patients will improve. When providers have access to vital patient information and consequently receive important alerts, patients benefit.”