Health leaders are interested in connecting up with other organizations — an interest documented by several studies — but many aren’t moving ahead. HIE expansion is proceeding slowly for a number of reasons, not the least of which are concerns about HIE costs and the great difficulty in establishing interoperable data streams.
But some of the reasons healthcare administrators cite for not moving ahead are actually myths, according to a story in Becker’s Hospital Review. Becker’s spoke with Carol Parker, executive director of the East Lansing, Mich-based Great Lakes Health Information Exchange, who argued that at least three common beliefs about HIEs are myths.
1. HIEs are costly. According to Parker, hospitals assume that HIE connections will prove to be as expensive as bringing an EMR on board, which naturally gives them pause. But the truth is that HIE costs are “negligible” compared to EMR expenses, Parker says. For example, she estimates that a 300-bed hospital would pay less than $50,000 per year, a very small number when compared to EMR costs.
2. HIEs are less secure than current systems. Providers worry that HIEs aren’t going to offer strong enough data security to ensure HIPAA compliance. In fact, according to a HIMSS Analytics report, 39 percent of hospitals who are already on board with HIEs have privacy concerns. But according to Parker, HIEs like hers have tight security measures in place. GLHIE even has a chief privacy and security officer who audits and monitors the data to make sure security meets government and industry standards.
3. HIEs don’t need to be a priority. According to Parker, providers overwhelmed by EMR installs have “IT fatigue” and don’t feel they can add this one more thing to their efforts. But Parker argues that participation in an HIE is critical, particularly as hospitals take on population health management, and work under performance-based contracts. “It will be challenging to make that work without having information on care delivered to the patient outside of the health system’s network,” she says.
While Parker is obviously biased in favor of HIEs, I believe she makes some good points. It’s particularly interesting to hear that the annual cost of HIE participation, at least with GLHIE, is a relatively small number. Now, just because it’s inexpensive doesn’t mean joining an HIE isn’t a big deal. But it’s good to hear that the costs are probably doable for most hospitals.
1. A primary concern for an HIE is sustainability. Any grant is short-lived, and many have ‘ died on the vine’ when the grant expired. The first users should be what I call “anchor tenants’. Just as in a real estate venture such as a shopping mall developers will obtain a commitment. This way it offers the HIE a year or so to commence the HIE. Often this alone stimulates and offers credibility to the HIE. Fees are usually calculated /bed. A discounted rate for the first two years may be offered for the first 2 or three subxcribers..
2. If the HIE chooses a proven vendor there should be no problem. Candidates are advised to ‘shop around’ and get references. However most HIPAA breaches are due to human error ie, a laptop left carelesslu, lost or stolen. The same precautions hold for HIE as EMR.
3. HIEs become more essential with the ACA, since a greater coordination of data is essentil if the users are part of an ACO. The return of investment becomes apparent with the decrease in unecessary repetition of expense testing. The amount of paperwork and delays in data transmission diminish greatly. IT fatigability should not enter the equation since most HIE vendors do 99% of the work once the HIE is established. The greatest part of the work load is recruitment of users, and educating potential users. Formation of a web site or blog can afford early visibiliity with news and announcements of progress and upcoming events. It allows for two way commmunication amongs all potential users. Facebook pages, or Google pages are very valuable.
Note; Coordination of efforts is essential with a program manager assigned. Initially this can be a part-time position to minimize overhead.