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Health Information Exchange: Where are we today?

Health Information Exchange (HIE) is “the development of secure health information exchange between healthcare providers…in order to improve the continuity and quality of care for patients.”[1] According to a recent research study, 71 percent of U.S. hospitals intend to purchase a HIE solution, with 25% intending to purchase it within a 7-to-12 month period.[2] States across the country are setting up HIEs in which providers and ACOs can participate to better integrate their health information.

Idaho, through IHDE (Idaho Health Data Exchange), has helped groups like Primary Health Medical Group (PHMG) access patient information such as admission and discharge summaries, as well as physical and lab test results, better understand its patients’ medical history before diagnosing and implementing treatment. As a result, PHMG is preparing a multi-phase approach to its participation in which the intended end result is the statewide availability of the 200,000 patients it sees annually.[3]

The Kansas Health Information Exchange (KHIE) was intended to be a government HIE but evolved into a public-private share entity with private funding from the Kansas Hospital Association and the Kansas Medical Society. Now its operations are being handed over to the state completely, with leadership citing cost issues. As a private, independent entity, KHIE’s staffing costs were as high as $400,000 a year. As a government entity, however, its staffing costs are expected to fall to $54,000 a year. The board is hoping this will force the government to “have some skin in the game,” thereby giving more attention to the providers whose participation will ultimately benefit the patient.[4]

Michigan Health Connect (MHC), Michigan’s largest health information exchange, recently teamed up with Greenway Medical Technologies to provide Michigan providers and physicians real-time access to clinical data leading to more than 900,000 results per month. The partnership is geared toward ambulatory practices and clinics, and will include 54 member MHC member hospitals and more than 4,000 physicians across the state.[5]

Other states, like Montana, Colorado, and Florida, are also contracting with physicians to participate and share patient information with each other. However, which HIE solution is the best at the state level? Further, do we need HIE solutions to be operable only at the state level? Or should we be strategizing toward a solution that will eventually tie all state patient data into a national health information exchange? The Office of the National Coordinator for Health Information Technology is currently working with federal agencies, local and state governments, health information exchange organizations, and other entities to develop standards and policies at the national level. This group is formerly known as the NHIN (National Health Information Network) Cooperative and expected 35 participants in this network by the end of 2011. As of March 2012, it had 27.[6]

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