Staying up to date with HIE

GE Healthcare’s Earl Jones answers readers about health information exchanges.

“Don't wait to get engaged in an HIE. Joining an HIE will help you enable information to flow between providers more easily and quickly, supporting decision-making and enhancing continuity of care.”
-Earl Jones

The key to meaningful use appears to be the ability to send and receive data by connecting with IT systems in other locations via an HIE. What are the first steps I need to take to enable my organization to build or become part of such an exchange? Patrick Wylie, Chief Information Officer, Santa Rosa Memorial Hospital, CA

Earl Jones. Stakeholder engagement is the first step to organizational readiness. Helping the business, clinicians and patients understand how an HIE can help to bring better care at lower cost to the hospital and community will facilitate implementation and adoption. Articulating your organization's goals will help clarify program scope (what to implement) and will serve as a benchmark so that future results can be quantified.

The next step is to choose the right vendor – one who will stay with you for the long haul and who will implement a bi-directional, standards-based, semantically interoperable HIE infrastructure. This will help ensure that, as your organization's needs grow, your solution can grow with you.

Lastly, implement the HIE in stages, focusing first on quick wins that excite clinicians with minimal impact to existing workflows. That way, some success can be achieved quickly, and support for the next stages of implementation will increase.

What are the basic criteria I need to look for when deciding which HIE to join? Steve Bateman, CTO, Brigham City Community Hospital, Brigham City, UT

EJ. Today, the majority of health providers are driving toward establishing a way to exchange health information. However, there are some areas where early adoption has led to multiple HIE options for a given provider.

AHRQ, the Agency for Healthcare Research and Quality, suggests that your organization evaluate your needs and align to the HIE that best fits your business and IT goals. Important criteria include network design and functionality, overall leadership compatibility, and billing structure or fees. In addition, consider the overall sustainability of the HIE and carefully review the data sharing agreement.

Don't wait to get engaged in an HIE. Joining an HIE will help you enable information to flow between providers more easily and quickly, supporting decision-making and enhancing continuity of care. In the future, many HIEs will likely also be connected to regional and state networks, resulting in broadly connected communities.

If I have the choice between joining an HIE and a RHIO, how can I decide which one suits my institution? Laura Keithahn, Director of Technology, St. John's Hospital, Saint Paul, MN

EJ. The decision to join an HIE or RHIO should be based on your organization's objectives such as increasing revenue, improving patient satisfaction, meeting quality goals, and achieving meaningful use.

An HIE generally ties affiliated providers together to enable interaction across the virtual enterprise and more efficiently coordinate access and use of shared services (such as referrals, lab, radiology, and cardiology). In addition to linking in the referral network, an HIE can simplify the manual processes for sharing information.

RHIOs typically have a larger, more regional focus across multiple independent and sometimes competitive stakeholders. RHIOs can support a loose coupling of such stakeholders across a larger region and provide a platform for competitive differentiation and expansion of services. A RHIO can also form when there are referral patterns across regional hospitals, such as a community hospital that sends its patients to a larger health system.

There's so much emphasis right now on EHR and HIE. How can we ensure that the systems we end up implementing are sustainable in the long term? Sheryl Bell, Director of Information Services, St. Luke's Medical Center, Boise, ID

EJ. First, invest in robust, scalable HIE infrastructure that is bi-directional, standards-based and offers options for integration to existing EMRs as well as portal-based solutions for non-EMR users. The best standards come from IHE, a global organization that defines interoperability 'profiles' that package standards to achieve specific use cases, ensuring tight alignment to business objectives. With such an infrastructure, your HIE will be scalable and can support additional stakeholders and patient populations for varied business models and future community workflows. Also, consider a hosted solution, which has less upfront capital expense, outsources operational risk to the vendor, and has flexible 'pay as you go' fee structures.

Ask your HIE technology partners to explain their near- and long-term roadmaps for value-added functionality. Finally, given the turbulence in this new market, it is wise to partner with a reputable and stable company.

Earl Jones is Vice President, GE Healthcare eHealth Solutions. With six years at GE, he brings a wealth of experience from previous roles as partner of a consulting firm, leader at Dell, achieving an MBA from MIT, and serving with distinction as an Officer in the US Navy's Submarine Force.