While HIEs are expanding their offerings to include analytic and care coordination functions useful for population health management, they aren’t doing it quickly enough to meet market demand, according to a piece in Information Week.
The IW story, which outlines the conclusions of a new report from Chilmark Research, notes that the focus of most HIEs is still on secure clinical messaging, which is not adequate for cross-enterprise care coordination. The Chilmark report estimates that queries of databases for patient info needed at the point of care account for just 2 percent to 10 percent of HIE transactions overall.
Information Week also drew attention to a study appearing in Health Affairs noting that the most common functions of the 119 operational public HIEs were transmitting lab results, clinical summaries and discharge summaries. While there’s been a large increase in the number of HIEs that can exchange Continuity of Care Documents, few EMRs can integrate the data components of CCDs in to structured fields, the Health Affairs piece noted.
The problem is particularly acute in ambulatory care. As Chilmark CEO John Moore told Information Week, most ambulatory EMRs haven’t been able to generate CCDs that other EMRs can consume or do queries using a record locator service. “The value that HIEs provide to the ambulatory sector, where 80 percent of care takes place, is pretty limited,” Moore told IW.
Still, despite their weaknesses, public HIEs continue to hold onto life. For example, as various industry stats have shown, hospital CIOs increasingly see participation in an HIE as a key initiative, if nothing else because Meaningful Use will eventually demand interoperability.
But as the Chilmark study emphasizes, HIEs have a long way to go before they’re making a major contribution to patient care. And getting enough momentum to address these problems seems elusive. All told, while HIEs are clearly an important movement, getting them to the point of true usefulness could take years more.