“We have a very diverse group of [health information exchanges] that started in many different ways but are in some ways evolving in the same direction, which is an interesting trend,” said Kate Berry, CEO of the National eHealth Collaborative (NeHC), during a June 28 HIE Leaders Roundtable webinar hosted by the Washington, D.C.-based organization.
NeHC brought together 12 HIE leaders of operational HIEs together to talk about critical success factors for establishing an HIE and sustainability.
During the discussion, HIE leaders highlighted the importance of focusing on end users and making exchange easy for providers and vendors. They emphasized the importance of having core competencies in change management and workflow re-engineering.
Tom Fritz, CEO of Inland Northwest Health Services (INHS) in Spokane, Wash., said his organization provided a venue for collaboration for previously competing health organizations in its market.
“One of the things we developed 13 years ago was a shared-services model, which led to the development of our HIE,” said Fritz. “We were somewhat criticized at first … [but] ultimately reduced our costs. As an example, in our community, we had five acute-care hospitals. We reduced our data centers from five to four so we immediately saved millions of dollars in infrastructure costs and we began to standardize our hospital information systems.”
INHS also partnered with physicians, which was “one of the most important things to determine value to our system.” Moving forward, Fritz said he expects more services to be developed including data analytics. “We stay away from transaction fees.”
HealthInfoNet, the state-designated HIE for Maine, was created in 2005 and has been operational for three years, shared Devore Culver, executive director and CEO of the HIE. About 67 percent of the population of the state, or 900,000 patients, are included in the data and HealthInfoNet is connected to 16 hospitals, Culver stated. “We are growing this year by another eight hospitals.”
The HIE is currently sustained partially by subscription fees and partially by contract fees as well as federal funds, but the federal funding will run out, so “our focus in sustainability is moving to direct-value services,” Culver said.
Echoing Fritz, John Blair, CEO of MedAllies, of Fishkill, N.Y., advised, “Develop relationships with providers early and target your efforts to resolve their day-to-day concerns. We went in early with providers and their vendors and asked, ‘How do we make this work for you?’ We articulated a vision, a way for vendors to connect to each other through our HIE. It was logical and made sense to everyone.”
MedAllies reaches about 2,000 providers in the Hudson Valley where about 1,500 use the HIE that the organization developed, according to Blair. “In terms of patient-centered medical homes and transformation, [of our 2,000] primary care providers, over 300 were able to get to level 3 National Committee for Quality Assurance recognition in an 18-month period,” he said. MedAllies is interested in participating in the Direct Project going forward, Blair added.
Mark Jones, COO and principal investigator at SMRTNET, highlighted the importance of third-party support and guidance in the development and growth of its networks. “The success of the seven SMRTNET networks in Oklahoma is largely attributable to the Agency for Healthcare Research and Quality developing a support network through its Transforming Healthcare Quality Through IT grant program of experienced and successful experts,” he said. “These experts acted as guiding hands for our critical issues as we built the capacities that we needed. I think our project might have failed without that support.”
The ability to access "a neutral source" that has already objectively demonstrated success helped the SMRTNET projects avoid some of the pitfalls that frequently cause HIE projects to lose momentum, Jones said.