Enterprise HIE vs Public HIE

I was recently listening to an interview with a hospital CIO talking about their move to becoming an ACO and the various ACO initiatives. As part of the interview the hospital CIO was asked about HIEs and how they were approaching the various HIE models. His answer focused on their internal efforts to create what he called an Enterprise HIE.

I think it’s telling that even within a hospital system they haven’t figured out how to exchange health information. They control the end points (at least in large part) and yet they still have a challenge of exchanging information between their own provider organization.

One trend that is causing the above challenge has to do with hospitals acquiring medical practices. As you acquire a practice or even acquire a hospital there’s often a challenge associated with getting everyone on the same IT system. Plus, even within one hospital they use hundreds of different applications to capture clinical content. Thus the need to create an enterprise HIE.

I think that the idea of hospitals building enterprise HIEs puts some context on public HIE efforts. First, if hospital organizations are having a challenge putting together an internal enterprise HIE, it’s no wonder that public HIEs are having such a challenge. If hospitals don’t have their own houses in order, how could they export that to a public HIE?

In that same interview I mentioned above, the hospital CIO said that he was monitoring the other HIE initiatives in his area. However, he said that he believed that we were far from seeing HIEs really take off and be used widely. Obviously each HIE is very regional in nature since healthcare is mostly regional in nature. However, it was a telling message about the slow pace of HIE.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

1 Comment

  • I believe some hospital groups (as I define it, one or more hospitals plus ‘attached’ medical practices plus optionally individual doctors and practices who are offered and accept the ambulatory EHR from the group) are making a point of doing this. But ones I’m aware of are not all that far along for various reasons. First, it does take quite a while to convert practices from paper. Second, some parts (practices or departments) have EHR’s already and either need to be connected or have their EHR replaced; not easy either. It may not be all that ‘hard’ to migrate a small practice to EHR, but multiple practices with many specialties plus a multi hospital group; that’s huge and complex. BUT if and when it has been well accomplished, you ought to then be able to start collecting – and harvesting data about outcomes, and you certainly should already be improving care and cutting costs by eliminating duplicate tests, etc. But even then, if you don’t connect to outside practices and hospitals with different EHRs, you still will waste.

    My favorite example; you go for a procedure and imaging at hospital group A. Weeks later, you end up in the ER somewhere in group B. Each has great systems, but they don’t talk to each other. Hence, all new imaging, etc.

    How can one expect to go the ACO route before this is overcome? Especially if you think ‘my HIE’ versus ‘their HIE’?

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