Cal INDEX officials should already be approaching as many potential subscribers as possible, Kansky says. "'What would this exchange have to do for you in three years in order for you to pay for it?'" he said. "That's the question they should be asking everyone."
Indiana's HIE built a sustainable public-private business model by offering data and data services to a wide range of healthcare industry stakeholders. "We have multiple services to multiple sectors in healthcare," Kansky says, noting that IHIE subscribers include physicians, hospitals, laboratories, imaging centers, payers, and nursing homes. IHIE officials are constantly eyeing new markets, including self-insured employers, patients, and home care organizations.
In addition to having a large portfolio of data services to offer, successful health information exchanges must focus on establishing data use agreements with the organizations that are providing the data, Kansky says.
"When you agree to participate and pay fees, you also agree to provide data… It's not our data. There's this whole concept of data governance," he says of the process involved in setting rules for the use and sharing of HIE information. "Your partners absolutely need to trust you [and know] how the data is going to be used and not used."
No matter how well a state-based HIE is designed and managed, it will have inherent limitations and will likely be unable to slake the thirst of clinicians seeking "the complete picture" of their patients, according to Brian Baum, CEO of West Friendship, MD-based vitaTrackr Inc.
"Counter to the Indiana experience, I think the state-based health information exchanges… are building an infrastructure for yesterday's healthcare," he said this week.
Christopher Cheney is the senior clinical care editor at HealthLeaders.