The recent announcements by the federal government of $547 million in grants to facilitate health information sharing at the state level is like Spring hitting the information exchange landscape.
But only HIEs that are carefully tended are likely to endure for seasons to come.
Managing patient and provider identities is a vital first step. While it's long been understood that accurate patient identification is foundational to data exchange, it's also true of providers' identities, including physicians, organizations, licensed professionals.
And these demands will only increase with the emphasis on new care delivery and payment models that are included in the recent health reform legislation.
While a national provider identifier exists, it does not answer the question of who the provider is, where they practice, where results should be routed, or where queries should be sent. Understanding a provider's relationship to the patient as well as their data may be vital as federal and state policies address privacy and consent management.
State-Designated Entities (SDEs), set-up to handle the HIE funds, will have to consider these requirements in addressing the complex challenges associated with developing consumer confidence and ensuring provider participation. Should they fail to address these requirements, and consumers or providers opt-out of these fledgling HIEs, precious time and millions of federal and state dollars risk being wasted.
Financial sustainability must be built-into planning. While the federal government is providing all the funding for the first year and 90 percent in the second, states must craft a business model that does not depend on grants and state allocations for ongoing funding.
SDEs must therefore define what value-added services they will provide – and charge – to the participants. This might include services such as records location or claims routing that allow providers to avoid the expense of point-to-point interfaces. Access to the Connect Gateway for disseminating information to federal agencies such as the Social Security Administration might be another value-added service.
Another approach might be to provide services focused on chronic diseases that demand care coordination for individual and population health. With that approach, HIEs might seek sponsorships from vendors in return for building awareness for their services among the provider community.
Although these options may not be ideal for any particular HIE, they highlight the need for seeds to be sown now to help HIEs thrive over the long term. That's the only way to ensure perennial returns for years to come.
-- Fernandes is vice president and healthcare industry ambassador for Initiate Systems Inc.
