From The Editor

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By Ken Congdon, editor in chief, Healthcare Technology Online

It seems like every year at HIMSS there's one overriding theme that dominates the exhibit floor. Last year, that theme was how to secure ARRA (The American Reinvestment & Recovery Act) stimulus funds through "meaningful use." While this topic was still central to this year's event, many of the exhibitors and educational sessions at HIMSS 2010 focused more on the role of HIE (health information exchange) in achieving meaningful use.

According to the now disbanded NAHIT (National Alliance for Health Information Technology), HIE is the electronic movement of health-related information among organizations according to nationally recognized standards. This has become such a central issue in the healthcare industry because it is the end goal of many of the federal government's EHR (electronic health record) incentives. In fact, in recently communicated meaningful use guidelines, standalone EHR applications will not qualify for stimulus funding. Instead, providers must share patient-specific clinical data electronically within a common HIE hosted by a local community or hospital. In other words, patient information stored at a physician's office or hospital must be able to be shared electronically with outside offices or hospitals within the community or region to qualify for stimulus funding.

While HIE is obviously vital to federal initiatives, adoption of these infrastructures is low. According to eHI (eHealth Initiative), there are only 193 HIEs in existence — only 57 of which are operational. The rest are still in their formative stages. As a result, exhibitor after exhibitor I spoke with at HIMSS this year focused on how they could help healthcare organizations achieve HIE success. For example, Bill Sims, VP of Medicity focused on how the company's Novo Grid technology is designed to make the transition to an HIE easier on physicians. Chris Stevens, CTO of Orion Health, focused on his company's success at developing a RHIO (Regional Health Information Organization) for the state of Maine and numerous HIEs for Canadian Provinces. Even a vendor such as MEDecision, which has historically been focused on the payer space, was heavily promoting its new inFrame solution — a provider HIE delivery platform designed to connect healthcare organizations on a local, national, and international scale.

THE CIO's ROLE IN HIE
More evidence of HIE's imprint on HIMSS 2010 was clear at a McKesson media breakfast I attended. The content presented at this breakfast focused (almost exclusively) on McKesson subsidiary RelayHealth. RelayHealth provides open network solutions that offer connectivity and interoperability of healthcare organizations, systems, and solutions. The feature presentation at this media breakfast was a Q&A session with a panel of CIO's from John Muir Health, St. Luke's Health System, and St. Peter's University Hospital — all of which have successfully deployed (or are deploying) RelayHealth for HIE initiatives in their communities.

Many important tips for CIOs to consider when deploying an HIE in their community were shared during this Q&A, but the one that stuck with me was the need for the CIO to break outside their comfort zone and serve as a trailblazer in their community in order to make an HIE initiative work. For example, neighboring hospitals and health systems have historically been very competitive and protective of their patients as clients. HIEs require hospitals and health systems to reach across enemy lines and work together with their neighboring rivals in order to make an HIE work. This change in behavior will likely be difficult for many, but the CIOs that take the lead on these initiatives will be most instrumental at forming the communication network that will serve as the foundation for improving patient care in their communities for years to come.

Ken Congdon is Editor In Chief of Healthcare Technology Online. He can be reached at ken.congdon@jamesonpublishing.com.