10th Annual Health Information Exchange Survey Results

11-7-2013 9-51-28 PM

The Washington, DC-based HIE advocacy group eHealth Initiative publishes its 10th annual survey measuring the growth of health information exchange projects across the nation. The results shed an interesting behind-the-scenes perspective on HIEs, a group that has historically struggled to achieve a sustainable business model, but are nonetheless an important part of the health IT ecosystem.

This year’s survey identified 315 active health information exchanges operating in the US, up from 300 last year. 200 of those organizations responded to the survey. The organizations represented in the survey include large statewide networks, smaller community-based data exchanges, and a variety of exchanges setup to support private health systems.

Most organizations report that achieving interoperability remains a top concern, saying that sharing clinical data outside of a health system remains a difficult and expensive proposition. 68 of the 200 responding HIEs report that they are supporting interfaces with more than 10 different EHR systems. To address this problem, most organizations agreed that they would like to see standardized exchange solutions offered by EHR vendors.

Currently, a wide variety of different approaches to information exchange are being employed across the HIE landscape. 125 organizations use a query model, 124 use secure electronic messaging, 111 use end-to-end integration, and 84 respondents use a combination of models. 45 percent of the networks reported that they had implemented Direct secure communications protocol.

Despite the $25 billion dollars being invested in health IT through the HITECH act, only 50 percent of the HIEs are currently capable of sending and receiving a continuity of care documents, a requirement for stage 1 Meaningful Use.

One quarter of the HIEs are currently working with ACOs, or are actively working toward supporting an ACO. Respondents listed a variety of different strategies that they would pursue to enhance their ability to support ACOs, including:

  • Offering alerts to providers
  • Connecting to other local networks
  • Offering patients access to their data.
  • Analytics services
  • Image exchange

Patient engagement among HIEs remains nearly non-existent. Only 31 of the 200 HIEs offer patients the ability to access their own information, and only 17 support the ability of patients to contribute information to their record. Opt-out is the most common consent model. A vast majority do not offer patients the ability to limit sharing of their information.

On a bright note, most organizations are reporting greater revenue this year than last, suggesting that the HIE market may finally be ready to financial support these organizations. Currently, only 25 percent of respondents report that they are earning enough revenue to sustain operations independently.

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