Health Information Exchanges: An Integral Component For Optimizing Value-based Care

This content was originally created by Galen Healthcare, now part of RLDatix.

Abstract

Health information exchange (HIE) organizations have proven themselves effective and efficient in coping with many of the interoperability challenges faced by the healthcare industry today. However, many HIEs were financed by public programs whose funding limits have now been reached. HIEs will need to quickly become self sustaining if they are to continue delivering desperately needed services.

The good news is that there are many strong HIEs that are delivering continuous value to their communities. Other HIEs have the opportunity to look to them for guidance and best practices. As they are a linchpin to delivering the interoperability needed for value-based care, it is critical for HIEs to follow best practices, increase capabilities, and expand adoption.

This whitepaper provides HIE definitions and background, describes the components of an HIE, and elaborates on advanced use cases that provide for compelling value proposition and foster sustainability.

"HIEs don’t have a right to exist just because we’re HIEs. We should only exist if we are indeed adding value, like any other business or
organization would have to do. I think what we will continue to see is those that haven’t figured out how to do that well will be challenged. There may still be some consolidation, or HIEs that cease to exist, if they haven’t put a sustainability model together. That shouldn’t mean that the whole concept is wrong, just that, like in any business, some work and some don’t. For example, there are some that know how to run a book store and some that don’t, and the bad book stores go away and the good ones continue to exist. So, I welcome that scrutiny and what it will mean for what we’re doing to enhance care coordination and facilitate cost optimization.”

Doug Dietzman, Executive Director, Great
Lakes Health Connect

HIE definition

According to HealthIT.gov, HIEs allow doctors, nurses, pharmacists, other health care providers, and patients to appropriately access and securely share a patient’s vital medical information electronically. HIEs can greatly improve the speed, quality, safety, and cost of patient care during medical data transfer. There are three distinct types of HIEs in the marketplace now:

• Directed Exchange – ability to send and receive secure information electronically between care providers to support coordinated care.
• Query-Based Exchange – ability for providers to find and/or request information about a patient from other providers, often used for unplanned care.
• Consumer-Mediated Exchange – ability for patients to aggregate and control the use of their health information among providers