3 Secrets Of Successful HIEs

By Ken Congdon, editor in chief, Health IT Outcomes

HIE (health information exchange) is at the core of true healthcare interoperability. The federal government realizes this, and has devoted more than half a billion dollars in grants to the states for the sole purpose of establishing statewide HIEs. Many municipalities and states have taken advantage of these grants and have worked to lay the groundwork for effective data exchange among neighboring healthcare providers. However, in recent months, the focus has been more on whether or not these HIEs will be sustainable after the federal funding runs out in 2015, instead of on how successful HIEs can benefit our healthcare system. See my November 2011 article titled Are HIEs Sustainable? for more on this topic.

There's no question that some of the HIEs established using federal funds will falter once the grants are gone. However, others will continue to thrive because of how they were constructed and how they are managed. Recently, IDC Health Insights set out to uncover the best practices of successful HIEs. The analyst firm interviewed nearly 50 executives from enterprise, regional, and statewide HIEs, and published their findings in a report titled Best Practices: Establishing Sustainable Health Information Exchange.

The report provides a framework for establishing a new HIE based on the keen insight from successful early adopters. Specifically, the report outlines three key traits common to all successful HIEs interviewed for the study. These traits are as follows:

1. Stakeholder Buy-In — The IDC report clearly shows that successful HIEs do a good job of communicating with all project stakeholders (e.g. hospital leadership, clinicians, practice administrators, payers, etc.) on all critical aspects of the HIE implementation. Successful HIEs ensure all stakeholders understand the clinical, business, and technical requirements necessary for the HIE and involve these stakeholders in identifying and conducting potential vendor solutions. This open communication creates an environment built on trust, which is essential for a successful outcome.

2. Data Flow Intelligence — Successful HIEs also had a high level of insight into their data flow. For example, these HIEs developed an inventory of what data was available electronically and what data was not during the early HIE planning stages. This effort allows HIEs to better understand how data will flow among participants. Secondly, successful HIEs also stress the importance of closely monitoring data feeds from each stakeholder.
3. Sustainability — Finally, successful HIEs anticipate that resolving privacy and security issues takes longer than resolving technology issues. As such, successful HIEs view project sustainability — from both a security and financial perspective — as a crucial part of their initial planning. IDC Health Insights Program Director Lynne A. Dunbrack summed up this trait best by saying, "Too many HIEs have relied on the ‘build and they will come' strategy. Instead, successful HIEs must plan for sustainability from the very beginning. If the HIE will not be sustainable after the initial funding, then careful consideration should be given to wheter to launch the HIE in the first place."