Take Charge Of Your HIE

By Ken Congdon, editor in chief, Health IT Outcomes

Several months ago, I penned an article titled Are HIEs Sustainable?, that questioned whether or not many statewide and regional HIEs established using federal grants will be able to survive once this funding runs out in 2015. Certainly, many of these organizations will face sustainability challenges when forced to pay for themselves, and many believe the root cause of these issues is the manner in which many of these HIEs were established in the first place.

“Many statewide HIEs or RHIOs [Regional Health Information Organizations] were formed using a centralized model where providers are basically asked to submit their electronic patient information to a collective data pool that all members of the HIE can access,” says David Caldwell, executive VP of Certify Data Systems. “This centralized model typically isn’t an attractive option in a historically competitive healthcare environment. Few providers are comfortable placing all of their valuable patient information and demographics into a data pool for all of their competitors to see. A federated approach to HIE, where providers own their patient data, but submit it to other providers on a query basis [e.g. when a patient shows up in a competing hospital’s ER] is a preferred approach to HIE for most providers.”

Enterprise HIE Drives Business Value

However, even with a federated approach, many providers still don’t see the business value associated with public HIEs. There is value to the patient and to the healthcare system to be sure, but how can HIE help a provider’s business actually grow? The key, according to Caldwell, is to look at HIE as an enterprise venture first, and then expand upon it to meet regional or state demands.

Hospitals and health systems, for example, have a lot to gain from optimizing their enterprise HIE efforts. First, they can use the technology to provide a greater level of integration and interoperability between disparate IT systems. For example, when hospital systems (e.g. EHR, laboratory, pharmacy, radiology, etc.) are siloed, paper is often introduced into the workflow and information often needs to be manually keyed into the EHR, which can introduce added labor and inaccuracies. When a hospital integrates its EHR with its laboratory and radiology systems, it can expedite care and increase operational efficiencies. When these systems are interconnected, physicians can not only order tests, but also access lab results and medical images electronically from the EHR interface.

“When a health system’s EHR is truly integrated with its laboratory system, it allows the provider to compete more effectively with national labs such as LabCorp and Quest Diagnostics,” says Caldwell. “Prior to HIE, most health systems just didn’t have the technology tools necessary to offer physicians the same result turnaround, access, and reporting capabilities as the national labs. With HIE, they can now offer physicians an equally, or more compelling, laboratory solution.”

This leads to a second business benefit of HIE for hospitals and health systems — physician recruitment. Historically, health systems have been notorious for flooding a physician’s practice with paper, which makes it harder for doctors to practice medicine and can increase their operational costs. With HIE, a health system can exchange data with physicians electronically, eliminating much of this paperwork, and making it easier for physicians to do business with them. Physicians will then be compelled to refer their patients to these health systems.

“Health systems consider independent physicians to be their trading partners,” says Caldwell. “They must engage and align with these physicians in order to survive and thrive. In fact, it’s been estimated that a single physician drives an average of $1.5 million in annual revenue to a hospital. With HIE, a health system can attract more physicians by creating an environment where it is easier for them to care for patients. This, in turn, will help increase the health system’s overall revenue.”