2019 HIE Survey DRAFT RESULTS 4.16 - Orion Health · 2019 HIE Survey DRAFT RESULTS –4.16.19. 2 Background on Survey Administered February 19, 2019 –April 12, 2019 through SurveyMonkey

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2019 HIE Survey

DRAFT RESULTS – 4.16.19

2

Background on Survey

▪ Administered February 19, 2019 – April 12, 2019 through SurveyMonkey Link

▪ Responses fielded through Constant Contact and personal Microsoft Outlook emails. eHIstaff made numerous follow-up calls to those on list.

▪ Almost 90 initial respondents

▪ 53 validated for completeness andname/title/organization

▪ Still reviewing data

Demographics of Respondents

3

DRAFT – Preliminary Results

States Participating in Survey

4

States with at least one respondent


Organizational Structure (Self-Described)

5

20

12

2

32

Organizational Structure Choices

Responses (Could select more than one)

Regional or community 60% 32

State-designated 38% 20

Private/Proprietary 23% 12

Hybrid 4% 2


How many payers participate in your exchange?

6

20

12

2

32Number of Payers

in HIE Responses

0 15% 8

1 -3 34% 18

4-10 38% 20

11 or more 13% 7


How many members are represented by payers in the HIEs?

7

20

12

2

32

7

8

18

20

20

7

Answer Choices Responses

< 1 Million 34% 18

1 - 3 Million 23% 12

More than 3 Million but less than 5 Million 9% 5

5 - 10 Million 15% 8

> 10 Million 0% 0

Not sure 19% 10

Answered 53

8

Respondents Organized by Participating Payers

Zero

▪ Clinical Connect HIE

▪ CommunityHealth IT

▪ HealthLINC

▪ HealthLinkNY

▪ Lewis and Clark Information Exchange

▪ Lincoln Land HIE

▪ Rio Grande Valley HIE

▪ SCHIEx

1-3

▪ Coastal Connect HIE

▪ ConnectHealthcare

▪ DHIN

▪ etHIN

▪ healtheConnect Alaska

▪ HealtheConnections

▪ HealthInfoNet

▪ Idaho Health Data Exchange

▪ Iowa HIN

▪ Massachusetts eHealth Institute

▪ Mass HIway

▪ North Dakota Health Information Network

▪ Paso del Norte HIE

▪ Quality Health Network

▪ Rochester RHIO

▪ South Dakota Health Link

▪ UP Health Care Solutions

▪ Wyoming Department of Health

4-10

▪ CORHIO

▪ Great Lakes Health Connect

▪ HASA

▪ Hawaii HIE

▪ HEALTHeLINK

▪ HealthShare Exchange

▪ Indiana HIE

▪ Keystone HIE

▪ Kansas HIN

▪ Michiana HIN

▪ MO Health Connection

▪ MyHealth Access Network

▪ NEHII

▪ New Mexico Health Information Collaborative

▪ Ohio Health Information Partnership

▪ Arkansas Office of HIT

▪ OneHealthPort

▪ San Diego Health Connect

▪ Utah HIN

▪ West Virginia Health Information Network

11 or More

▪ Agency for Health Care Administration

▪ CRISP

▪ Greater Houston Healthconnect

▪ Health Current

▪ Healthix

▪ The Health Collaborative

▪ WISHIN

9

Respondents Organized by Number of Members

Less than 1 million

▪ Arkansas Office of HIT

▪ CommunityHealth IT

▪ ConnectHealthcare

▪ etHIN

▪ healtheConnect Alaska

▪ HealthInfoNet

▪ HealthLinkNY

▪ Idaho Health Data Exchange

▪ Iowa HIN

▪ Michiana HIN

▪ New Mexico Health Information Collaborative

▪ North Dakota Health Information Network

▪ Paso del Norte HIE

▪ Quality Health Network

▪ South Dakota Health Link

▪ UP Health Care Solutions

▪ Wyoming Department of Health

▪ West Virginia Health Information Network

1-3 million

▪ HASA

▪ Hawaii HIE

▪ HealtheConnections

▪ HEALTHeLINK

▪ Kansas HIN

▪ Massachusetts eHealth Institute

▪ Mass HIway

▪ MyHealth Access Network

▪ NEHII

▪ Rochester RHIO

▪ Utah HIN

▪ WISHIN

3< and >5 million

▪ CORHIO

▪ Indiana HIE

▪ OneHealthPort

▪ San Diego Health Connect

▪ The Health Collaborative

5-10 million

▪ Agency for Health Care Administration (FL)

▪ CRISP

▪ Greater Houston Healthconnect

▪ Health Current

▪ Healthix

▪ HealthShare Exchange

▪ Keystone HIE

▪ Ohio Health Information Partnership

Not Sure

▪ Clinical Connect HIE

▪ Coastal Connect HIE

▪ DHIN

▪ Great Lakes Health Connect

▪ HealthLINC

▪ Lewis and Clark Information Exchange

▪ Lincoln Land HIE

▪ MO Health Connection

▪ Rio Grande Valley HIE

▪ SCHIEx

Business Drivers & Challenges

10


Biggest Business Drivers

11

20

12

2

32

7

8

18

20

20

7


Desire of stakeholders to manage risk and deliver on value-based care contracts 58% 31

Easier integration through APIs, FHIR, etc 47% 25

Provide clear value to end users such as care transition management and medication reconciliation 47% 25

Incentives from government agencies including CMS, state, and local authorities 34% 18

Increased demand for population health analytics tools 32% 17


"Value-based care trends influence my decisions about technology adoption."

12

20

12

2

32

of respondents somewhat or completely agree with this statement

92%


Top Priorities inNext Two Years

13


Enhance interoperability 47% 25

Support value-based care 43% 23

Integrate EMR and HIE workflows 40% 21Integrate non-traditional types of data like genomics and social 34% 18

Enhance care coordination 34% 18

Long term sustainability, financial viability 32% 17


Top Challenges Rated Significant or Very Significant

• Price/Cost (88%)

• Competing priorities (78%)

• Enhanced utilization and optimization of the solution (75%)

• Adaptability of the technology (61%)

• Technical Challenges (43%)

14


Technology Budgets Increasing

• 74% said their technology budget will likely increase over the next two years

• 14% said it will decrease

• 12% said no change

15

Integrating Claims & Clinical Data

16


How many HIEs have the capability to integrate claims and clinical data?

17

60% able to integrate



18

85% of the 3-10 million group (n=12) are able to integrate



19

Half of the 3 million and below group (n= 30) are still unable to

integrate clinical and claims data


Top Challenges Rated as Significant or Very Significant

20

• Data quality issues (60%)• Cost of technology (58%)• Availability of qualified staff (53%)• Claims data not available (46%)• Privacy/Security policies that limit

transactions (43%)


Have Seen a Significant or Very Significant Increase in Demand From

Payers for More Access to Clinical Data

21

67%

Services Offered

22


Technology Currently Already Adopted

23

We have already adopted this technology

Provider alerts 77% 40

HIE to HIE exchange 72% 38

Care coordination tools 40% 21

E-referrals/E-consults 21% 11

All payer claims database 15% 8

Medication reconciliation 11% 6

Remote patient monitoring 6% 3


Services Likely to be Offered in Next Two Years

24

Not likely or Not very likely Somewhat likely

Likely or Very Likely

We have already adopted

this technology

Provider alerts 2% 0% 19% 77%HIE to HIE exchange 4% 2% 19% 72%Care coordination tools 4% 11% 40% 40%E-referrals/E-consults 6% 28% 30% 21%All payer claims database 21% 15% 19% 15%Medication reconciliation 8% 30% 34% 11%Remote patient monitoring 40% 13% 17% 6%


The Services they are Providing to Payers are Valuable or Very Valuable

25

84%

Data Exchanged

26


Deep Dive – Care Coordination

Care Coordination is a priority for all size groups• HIEs in the 5-10 million members group have already

adopted this (88%) (n=8)

• Only a quarter of the 3-5 million members group have already adopted, but the remaining 75% are likely or likely to offer the service in the next two years (n=5)

• Only a quarter of the 1-3 million members group have already adopted, but another half are likely or very likely to adopt in the next two years (n=12)

• The less than 1 million members group is ahead of the game with 41% already adopting coordination and 59% reporting they are likely or very likely to adopt (n=18)

27


Deep Dive – All Payer Claims Database

• 63% of the 5-10 million members group have already adopted this and 25% are somewhat likely to adopt in the next two years (n=8)

• None of the HIEs in the 3-5 million members group have already adopted but half are likely or very likely to offer, while the other half are not likely or not very likely (n=5)

• Very few of the less than 3 million members group have already adopted (7%), and only 13% are likely or very likely to offer in the next two years. 50% said they are not very or not likely to adopt in the next two years (n=30)

28


Deep Dive –Remote Patient Monitoring

• Of the 5-10 million members group, only 29% have already adopted this and 14% will be likely or very likely to offer in the next two years. Overwhelmingly, 57% say they are not likely or not very likely to offer (n=8)

• 100% HIEs in the 3-5 million members are not likely or not very likely to adopt remote patient monitoring in the next two years (n=5)

• 50% of those in the less than 3 million members group are also not likely to adopt in the next two years (n=30)

29


Size Matters in Behavioral Health Data Exchange

30

▪ Of the HIEs whose payers represent up to 3 million members, two-thirds (66%) are experiencing difficulty in exchanging behavioral health data (n=30)

▪ 75% of HIEs with a bigger proportion of members represented by payers (3-10 million) did not report behavioral health data as difficult to exchange (n=12)


Quality Reporting Less Difficult for Smaller HIEs

31

▪ Half of HIEs with 3-10 million members represented by the payers in their exchange (50%) are having difficulty exchanging quality reporting data (n=12)

▪ Of the HIEs whose payers represent up to 3 million members, very few are having difficulty with this data (13%) (n=30)


Social Determinants of Health Data is Hard

32

▪ Across all organization sizes, HIEs are experiencing difficulty in exchanging Social Determinants of Health (SDOH) Data (52%)


Deep Dive - Medications Filled

33

▪ A larger proportion of HIEs with 5-10 million members represented by payers (50%) are having trouble with medications filled data compared with those in the less than 1 million group (33%); 1-3 million group (25%); and more than 3 million but less than 5 million group (25%)

DRAFT – Preliminary Results34

Radiology imaging studies are less difficult. Only 15% report difficulty

exchanging this data.

Progress in Exchanging Radiology Images

Other Points

35


Predicted Impact of TEFCA on Interoperability

• 60% said significant or very significant

• 25% said somewhat significant

• 15% said not significant or not very significant

36


Participation in SHIEC, eHealth Exchange, Direct Trust, SHIEC PCDH, Carequality,

and CommonWell

37

20

12

2

32


SHIEC 85% 44

eHealth Exchange 79% 41

Direct Trust 69% 36

SHIEC Patient Centered Data Home (PCDH) 58% 30

Carequality 15% 8

CommonWell 6% 3

None of the above 4% 2

Answered 52

Skipped 1


Next Steps

• Answer additional questions from Orion

• Finalize cleaning raw data

• Drafting conclusions about the data

• Preparing report – within two weeks

• Identify speakers from respondent list

38

Documents

2019 HIE Survey DRAFT RESULTS 4.16 - Orion Health · 2019 HIE Survey DRAFT RESULTS –4.16.19. 2 Background on Survey Administered February 19, 2019 –April 12, 2019 through SurveyMonkey