Physicians Warming to HIEs, but Interoperability Issues Linger

Over the last few weeks, there’s been a lot of attention paid to reports suggesting physicians are embracing data sharing via Health Information Exchanges (HIEs).

Nearly half of U.S. physician groups plan to join an HIE, according to a CapSite report released Sept. 28. Additionally, the fourth annual U.S. Ambulatory Electronic Health Record & Practice Management (PM) Study showed 43 percent of the 509,280 surveyed physicians indicated they plan to join an HIE. Also, according to the report, 56 percent of hospital-owned physician groups say they plan to join a state, hospital, or regional HIE.

The timing of the shift in attitude among doctors may, in part, have something to do with new Stage 2 requirements for CMS’ “meaningful use” program, which include a data sharing objective. Under the current final rule released in August, providers will have to demonstrate, and vendors will have to support, the exchange of structured care summaries with other providers and patients by 2014.

“There is no question that providers in this country have reached a point wherein they are not only interested in the electronic exchange of information but are willing to make the changes necessary on their part to make it a reality,” Leigh Burchell, VP of policy and government affairs for Allscripts and vice chair of the EHR Association, told Physicians Practice. “The increasing participation in both public and private HIE efforts, as well as those embracing other means of clinical data exchange, is driven in part by the positive impact on patient care and operational efficiency that comes from sharing clinical information. And the Meaningful use program, along with other payment reform initiatives that have been launched by government and private payers, is also solidifying the business case for care coordination and participation in health information exchange efforts.”

Interestingly, too, a greater number of physicians are consolidating into larger groups that are more likely to use HIEs, healthcare IT consultant Bruce Kleaveland noted.

However, interoperability issues and other challenges have the potential to throw off any well-meaning effort to achieve meaningful use in the second phase of the government’s program.

In a recent Bipartisan Policy Center survey, more than 70 percent of the physicians polled said that their EHR system was unable to communicate electronically with other systems due to a lack of interoperability. 

Getting a community with many competing interests to agree to co-fund an exchange that is interoperable  is difficult, as it takes a lot of time and a fair amount of capital to build all the connections between disparate IT systems, noted Kleaveland.

“It can be challenging to build a sustainable business model … many HIEs have been supported by government grants, which have finite term,” said Kleaveland. “The most sustainable HIEs are those that are funded by a sponsoring organization such as hospital, that is willing to invest in HIE in exchange for developing a closer link with admitting providers.”