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HIEs Essential in Fee-for-Value Era

Karen Minich-Pourshadi, for HealthLeaders Media, October 2, 2012

This article appears in the September 2012 issue of HealthLeaders magazine.

The pursuit of population health and value-based care may be reviving the business case for organizations to join health information exchanges. Now more than ever providers need accurate and complete patient data to effectively manage chronic care populations and attain incentive payments; this means healthcare organizations must have the ability to capture their own data as well as that of their affiliates and competitors. Health information exchanges just became an essential for providers looking to succeed in the fee-for-value era. 

An HIE is an organized regional network that enables hospitals, physicians, and other care providers to upload and access patient health information. HIEs connect data for organizations—from affiliates to competitors—to share clinical data that can improve a patient's overall care. The HIE is generally connected through a provider portal, giving easy access to clinical applications that allow caregivers to see all of the patient's clinical information in real time while restricting access to any claims data or other financial information. Early data indicates the HIE can reduce costs for participants.

In May, the Journal of the American Medical Information Association released a study of the members of the MidSouth eHealth Alliance in Memphis, Tenn., that focused on emergency department encounters and reported that the HIE was responsible for reduced costs of  $1.9 million and a net savings of $1.07 million; reduced admissions accounted for 97.6% of the total savings. The study looked at HIE use across 12 hospitals over a 13-month period and included 15,798 HIE encounters.

Though preliminary results indicate HIEs can help healthcare organizations save money, there's still reluctance by some in healthcare to participate in these exchanges. "It's understandable," says Steve Robertson, executive vice president and CIO at Hawai'i Pacific Health, a four-hospital system with three physician groups based in Honolulu. "There's still a lot of uncertainty about the cost that hasn't been worked out, especially in these very difficult economic realities of healthcare reimbursements, like who will pay for it—the government, the insurance companies, the laboratories, the hospitals, the physicians?"

Robertson, who manages IT for HPH as well as the revenue cycle, says healthcare leaders need to look at HIEs for long-term health improvements, not short-term tactical gains. An HIE allows immediate access to a patient's medical history for all providers involved in that patient's care, which makes information gathering and analysis easier for the physician and clinical staff, he says.

HPH helped to found the nonprofit Hawai'i Health Information Exchange in 2006 and has helped it evolve. The Hawai'i HIE is governed by its participants and is funded by participants, state grants, and donations. HPH recently donated more than $100,000 to the state HIE program.

HPH and its competitor, Queens Medical Center, exchange patient clinical information so if HPH patients receive treatment at Queens Medical, the doctors are able to access their medical records. "We've been able to save lives doing this," Robertson says.

"There is a competitive advantage to having data, and many healthcare organizations may not be willing to share with others. But patients can in some cases have five or more doctors working with them. It can be more dangerous for our patients if the data is fragmented, and that puts everyone involved at risk," says Robertson. 

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