Health Information Exchange in the U.S. Today

Where Emerging Technology and Functionality Meet

• 255 known HIE initiatives

• 127 initiatives have identified HIE vendorso 38% considered only 1-3 HIE vendors o 33% considered 4-6 HIE vendorso 29% considered 7-10 HIE vendors

Meaningful Use Stage 2 & HIE

• Top HIE vendors:o 22 OptumInsight, previously called Axolotlo 14 Medicity o 9 Cerner o 9 Mirth o 8 GE Healthcare o 8 IBM o 7 ICA

• 8 Reporting “Homegrown” Systems

Meaningful Use Stage 2 & HIE

• Move Data (Core Measures)o 65% ePrescribing + Formulary

Checking o Electronic availability of Patient Clinical

Summaryo 55% Lab Data into EHR

HIE and Meaningful Use Stage 2

• Move Data (Core Measures)o Patient online access to view, download

and transfer health datao Electronic Summary of Care Record for

TOC/Referralso Secured messaging to patientso Exception: Imaging results into EHR

(MENU)

HIE and Meaningful Use Stage 2

• Report Data o Ongoing Immunization Data Submission

(Core)o Ongoing Electronic Syndromic

Surveillance Data to Public Health (Menu)

HIE and Meaningful Use Stage 2

• Report Data o Ongoing Data submission to State

Cancer Registrieso Ongoing Data submission to Specialized

Registries

HIE and Meaningful Use Stage 2

• Clinical Quality Measureso 12 Data Pointso Electronically reported using PQRS

technical specificationso No longer a MU Measure o Now part of definition of “Meaningful

EHR User”

HIE and Meaningful Use Stage 2

• Platform Flexibility• Experience• Cost• Customer Service• Ease of Configuration• Speed to Deployment• Reputation

Key Attributes in HIE VendorSelection

• Poor Customer Service• Complexity in Configuration• Cost and Implementation Issues

25% Re-evaluating Vendor in Next 12 months

• Amount spent on HIE vendor:

HIE Initiatives and Spending

Last Fiscal Year Total$0 – 100,000 46

$100,001 – 300,000 18

$300,001 – 500,000 11

$500,001 – 700,000 7

$700,001 – 900,000 1

$900,001 – 1 Million 9

Over $1 Million 14

• 85 – Advanced / Full Operational HIEs• 54 – Independent of Federal Funding• 24 – Sustainable (an increase of 18

since 2010)

HIE Initiatives and Spending

• Revenue Sources:o 4 out of 24 HIEs – All Revenue from a

single sourceo 4 out of 24 HIEs – Receiving State /

Medicaid fundingo 20 out of 24 HIEs – Funding from a

variety of sources, typically hospitals, provider practices and payers

Sustainable HIE Initiatives

• 10 – Membership Fees• 9 – HIE Services Fees (E.g., PHR

Portal, Quality Reporting, etc.)• 4 – Federal Funds• 3 – Assessment Fees• 2 – State Appropriations / Grants• 2 – Usage / Transaction Fees• 1 – Taxation

Sustainability Models Include

• Adequate Funding? Resources? Knowledge?

• Broad range of approaches to all domains• Broad range of current readiness within the

states• With so much activity, and such a fast pace,

hard to get a handle on the “national landscape”

State HIE Challenges

Learn more about current health care industry issues, future legislation and how they affect providers and patientson our blog:

www.successehs.com/successtalk