HIEs Are Not Just for EHRs Anymore

Connecting HIEs with a “Universal” PHR

Robert Rowley, MD, Healthcare and health IT consultant, practicing family physician

Health Information Exchanges (HIEs) are hubs where different parts of the healthcare system can exchange information with each other. Doctors can communicate with other doctors, with hospitals, with labs, etc. Funding that encouraged the creation and maturation of HIEs were part of the 2009 American Reinvestment and Recovery Act (ARRA), just like Meaningful Use was also a part of the 2009 ARRA legislation.

Initially, HIEs were conceived as being regional or statewide entities (which received seed money through the Office of the National Coordinator for Health IT, or ONC) where everyone would connect, and would create an envisioned Nationwide Health Information Network (NwHIN) Exchange. More recently, the NwHIN Exchange (or simply, the Exchange) has moved away from being an ONC product, and towards becoming a public-private partnership that will encourage its growth in the coming months and years.

Adoption of this envisioned Exchange has lagged for a variety of reasons, some for technical reasons (lack of adoption of true standards by which different health information systems could communicate), and some for business reasons. The business reasons have been more problematic – why should competitors in healthcare share information with each other?

Separate from the national attempt to create a universal network of health exchange, private and proprietary health systems have created their own internal hubs – so-called “private HIEs.” Such organizations, such as academic medical centers and their surrounding clinics and doctors, or Accountable Care Organizations, have a compelling business reason for exchanging data – they need to provide efficiency and high quality and cost savings in order to stay afloat. And these “private HIEs” use the same kinds of technology that “public HIEs” use. In fact, software companies that build technology to support HIEs (there are about 20 large vendors, and a myriad of small startup companies with technologies in the connectivity space) have noted the greatest growth in their installation base among private HIEs.

Challenging the premise behind HIEs
HIEs were conceived as hubs for connecting health care providers. They were meant to Continue to Full Article…>>