Public vs Private HIEs: Which is right for me?

Public vs Private HIEs: Which is right for me?

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While we’ve talked about healthcare information exchanges (HIEs) in previous articles, we wanted to cover the topic in greater depth so that healthcare organizations could understand the true differences between public vs. private HIEs. By revealing some of the benefits of private and public exchanges, as well as some of the current challenges of implementation, you may begin to see the value of HIEs for your institution, and determine how to select one type of exchange over the other.

Differences between Private and Public HIEs:
While the goal of both private and public HIEs remains the same – the successful exchange of patient data for clinical decision support, improved patient outcomes and a lower overall cost of care – many differences exist between the two types of exchanges. The following chart breaks down some of the most common differences that we have observed:

Current Trends in the HIE Marketplace:
Since the 2009 HITECH Act, government funding provided for state-wide rollout of HIEs has dried up and will likely remain tight. Many HIEs have dissolved due to lack of sustainable operational costs. Public HIEs within states have been slow to mature for many reasons, but the primary problem has been that healthcare markets often cross state borders. Some of the most successful public HIEs started as smaller, regional HIEs or even private HIEs that offered a solution within a narrow geographic market. With effective leadership, engaged stakeholders, a defined strategy and the ability to create sustainable value early on in the process, successful HIEs have continued to expand to include more patients, hospital systems and geographic reach. We have also noticed a consolidation of HIEs in recent years. Competitive HIEs have realized that that they could operate better together to achieve their joint missions. The right HIE model will eventually materialize, but it’s clear that states are realizing the need to coordinate efforts. Until then, private, regionalized HIEs continue to dominate the market.

The breakdown of Private vs. Public HIEs Adoption:
Here are some recent statistics from a 2014 Black Book Rankings Report on HIE implementation:

  • 33 percent of multi-provider networks and hospital systems are considering private HIEs for more standardized sharing of patient data.
  • 82 percent of all payers and providers agree that an operational national public HIE is at least a decade off.
  • 92 percent of physicians, 81 percent of hospitals, and 94 percent of insurers/payers remain meaningful unconnected, in regards to intelligent interoperability.
  • Nearly all healthcare organizations, 98 percent, believe that private, community or regional HIEs are the preferred choice to comprehensively achieve accountable care organization deliverables.
  • Out of the some 30 percent of hospitals and providers using HIE solutions, the top complaint came down to lack of product integration and interface.

How can my health institution begin implementing an HIE?
Whether your state is a leader or still developing its statewide or regional HIE, we can help you uncover the best solution for taking advantage of the benefits that an HIE has to offer in your region. Alternatively, if a private HIE makes more sense, we can facilitate connecting with one or even help you with the process of developing your own HIE. While your immediate integration needs may dictate which type of HIE you implement at the start, the important thing to consider is how to see value beyond your EMR and begin to integrate with an HIE for the long-term purposes of population health, meaningful use and greater provider/patient engagement.

Healthcare information exchanges have helped many institutions reduce operational costs, avoid duplication, improve quality of healthcare and outcomes, strengthened ties between communities, and have begun to use data for research and modeling. With the right leadership and strategies in place, HIEs can continue to expand their reach and provide sustainable value for stakeholders, institutions and the public good.

Stay tuned for upcoming articles about some of the most successful state-wide HIEs in a coming article.