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Customer Experience and Design

Creating a Self-Sustaining Business Model for HIE

It is important for state and local agencies building an HIE solution to have a self-sustaining business model. This will be especially important once the federal government grant money ends. It is just as important for healthcare systems to consider the value proposition they need or want to get out of their HIE solution. Therefore, the HIE must be born from a strong business model that is self-sustaining and not overtly dependent on grant funding alone in order to be successful.

A strong business model must:

Be efficient in order to decrease the total cost of ownership: The HIE needs to be easy and cost effective to adopt but, more importantly must provide consumers of the HIE services a value-added proposition. The HIE must help physicians be more efficient and effective in their delivery of healthcare services to their existing and potential patient population. The HIE must not encumber the delivery of care by slowing down or preventing a physician in delivering patient healthcare services. If the solution does not effectively improve patient services, access and outcomes, the utilization and adoption will be negatively impacted.

Deliver demonstrable value to the key stakeholders in the process: The most obvious benefactors of the HIE are the physicians and patients that are part of the community that is supported by the HIE. Whether it is empowering physicians or patients with clinical information or aligning more effectively patients with physician services, the HIE must enable this relationship to thrive and flourish. In addition, healthcare systems will benefit by aligning these two parties and therefore creating a more cost effective, preventive care delivery system that will reduce costs by minimizing the number of ER and acute care admissions through these preventive care services.

Serve as a platform for enabling additional value-add services that create additional sources for funding and financial support: The HIE can be the platform to which additional services can be added outside of the standard clinical results and care model. Additional services such as ePrescribing, eReferral Management, Medical Home and Disease State Management services are just a few of the features that can be added and drive additional value to the consumers of the HIE solution platform.

Promote cost effective health care services and or materials: Cost-effective measures include discount prescription drug programs, preventive disease-management programs and overall health education programs to promote the wellness of the citizens of that geographic area.

Reside within the context of a flexible eco-system: This flexibility will enable other services such as eligibility checking for citizen’s healthcare insurance coverage. With the advent of healthcare reform, this strong business model will provide an efficient foundation upon which many more citizens can be incorporated into and will drive a more effective use of the HIE ecosystem.

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