HIE (Health Information Exchange) is a really interesting thing. It’s something we all know we want to have happen and so far millions and millions of dollars later no one has been able to crack the code on how to make an HIE a reality.
The benefits of having an HIE are real and apparent. I’ve never heard anyone argue about whether an HIE would bring benefits to healthcare. It’s simple to see that having all of your health information available to a doctor at the point of care is valuable and useful. We don’t need a study to show that. We know it’s the case. Having the information could be the difference between life or death.
We all know that if a doctor can get the lab or radiology information from the HIE, then they don’t have to order another duplicate lab or x-ray. They might still order another one (for a bunch of perverse and maybe some legitimate reasons), but in many cases they wouldn’t have to order one since they’d already have the info they need.
Why then isn’t HIE a reality today?
For the longest time I’ve argued that there are two main barriers to HIE: governance and funding. By governance I mean, “How are we going to make sure that the right people get the right information and that the wrong people don’t get the information they shouldn’t have?” Funding is really about finding a sustainable revenue model for an HIE.
While I still think that both of these issues are real challenges for HIE, I recently started to wonder if the real challenge for an HIE is that not enough doctors and hospitals are using EHR. We want HIE’s to be successful, but can an HIE be really successful for doctors and hospitals that don’t have an EHR?
The lack of EHR adoption might be the biggest impediment to HIE.