2 responses

  1. peter macisaac
    June 21, 2013

    Thanks for the overview.

    Australia and France are two countries where the start of HIE is a top down national program to provide a personally controlled EHR as the first objective, with health care professional access as a fully patient controlled secondary objective. Australia is starting with one national IHE based affinity domain, rather than using the regional and Connect based sharing model.

    Time will tell if this approach actually works for anyone! However from an exploration perspective issues such as minor access, access for parents, carers and so on have been developed and operationalised in a HIE framework. For those looking to see what Australia is doing search for Personally Controlled EHR.

    Peter MacIsaac, Health Informatician.

  2. Dr Ed
    June 21, 2013

    Health Information Exchanges are an interesting concept that has no apparent business model. In reality providers often prefer to NOT have patient data available to other providers (AKA ‘competitors). And providers sure don’t want to pay for the opportunity to lose control of their client’s (AKA Patient’s) data. This is why past efforts to ‘share patient data’ (i.e. CHIN, RHIO, etc.) died when the grant funding dried up.

    Similarly providers tend to want to keep their patients from heading to other providers so giving them a non-tethered PHR/service often runs contrary to their economics. Sadly consumers tend to be disengaged with their health/care until they are sick and then it’s often too late to ‘collect/control’ their data.

    Until consumers take a more active role (perhaps driven by rising patient contribution to costs / HDHP/HSA) the demand for HIEs and transportable PHRs appears nominal. It’s fine to pretend otherwise but that appears Pollyannaish to typical market participants.

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