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CIO Reveals Secrets to HIE

Posted on July 3, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Inspira Health Network is a community health system comprising three hospitals in southern New Jersey, with more than 5,000 employees and 800 affiliated physicians. It is an early adopter of health information exchange technology. In this Q&A-style paper their CIO and Director of Ambulatory Informatics share secrets to their successful Health Information Exchange implementation.

One of the most impressive numbers from their HIE implementation is that they were able to get 600 providers using the portal and 36 EMRs connected. Plus, they were able to get their HIE up and running in 4 months while many of the public HIEs were still working on their implementations. As I’ve written about previously, I see a lot of potential in the Private HIE. So, it’s great to see a first hand account from a CIO about their private HIE implementation.

Here are some of the other benefits the CIO identifies in the paper:

  • Ties the Physician Community to the Organization
  • Helps Meet the Meaningful Use Patient Engagement Requirements
  • Helps Address Care Coordination Requirements
  • Paper, Postage, and Staff Resource Savings
  • Improve Patient Length of Stay

Check out the full Q&A for a lot of other insights including rolling out the HIE to doctors who have an EMR and those who don’t. I also love that the CIO confirmed that the biggest technical challenge is that every EHR vendor has interpreted the HL7 standard differently based on the technical limitations of the application. This is why I’m so impressed that they were able to get 36 EMRs connected.

I hope more CIOs will share their stories of success. We’ve heard enough bad news in healthcare IT. I want to cover more health IT success stories.

Private HIE’s Will Make Nationwide HIE Possible

Posted on June 14, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’ve been working for a long time on creating a nationwide HIE. I still remember when I first started blogging about EMR 7.5 years ago we were talking about implementing RHIO’s. I’m sure someone reading this blog can talk about what the exchange of health data was before RHIO’s. The irony is that we keep talking about creating this beautiful exchange of information, but it never really becomes a reality.

As I look at the landscape, there are very few HIEs that are showing a viable business model. The two leaders I think are probably the Indiana HIE and the Maine HIE. They seem to be the two making the most progress. I think there’s also something going on in Massachusetts, but it’s so complicated of a healthcare environment that I’m not sure how much is reality and hyperbole.

With those exceptions, I’m mostly seeing a lot of talk about some sort of community HIE and not very much action. However, I am seeing quite a few organizations starting to take the idea of a private HIE quite seriously. I’m not sure if this is driven by ACOs, by hospital consolidation, or some other force, but the move to implement a private HIE is happening in many health systems.

For a lot of reasons this makes sense. There is a business reason to create a private HIE and you own all the endpoints, so it’s easier to create consensus.

As I look across the landscape, I think these private HIEs could be what makes the nationwide HIE possible. Once a whole series of large private HIEs are in place, then it’s much easier to just connect the private HIEs than it is to try and connect each of the individual healthcare organizations.

Watch for the major hospital CIOs to meet at events like CHIME or HIMSS and discuss connecting their private HIEs. It will create some unlikely relationships, but it could be our greatest hope for a nationwide HIE.

Enterprise HIE vs Public HIE

Posted on September 28, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was recently listening to an interview with a hospital CIO talking about their move to becoming an ACO and the various ACO initiatives. As part of the interview the hospital CIO was asked about HIEs and how they were approaching the various HIE models. His answer focused on their internal efforts to create what he called an Enterprise HIE.

I think it’s telling that even within a hospital system they haven’t figured out how to exchange health information. They control the end points (at least in large part) and yet they still have a challenge of exchanging information between their own provider organization.

One trend that is causing the above challenge has to do with hospitals acquiring medical practices. As you acquire a practice or even acquire a hospital there’s often a challenge associated with getting everyone on the same IT system. Plus, even within one hospital they use hundreds of different applications to capture clinical content. Thus the need to create an enterprise HIE.

I think that the idea of hospitals building enterprise HIEs puts some context on public HIE efforts. First, if hospital organizations are having a challenge putting together an internal enterprise HIE, it’s no wonder that public HIEs are having such a challenge. If hospitals don’t have their own houses in order, how could they export that to a public HIE?

In that same interview I mentioned above, the hospital CIO said that he was monitoring the other HIE initiatives in his area. However, he said that he believed that we were far from seeing HIEs really take off and be used widely. Obviously each HIE is very regional in nature since healthcare is mostly regional in nature. However, it was a telling message about the slow pace of HIE.

Good Luck With That HIE Tech Purchase

Posted on June 21, 2012 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Want to buy HIE technology?  It’ll cost you. But more importantly, you’ll still be dealing with a bewildering array of choices, if a new report from KLAS has it right.

According to KLAS, which asked 95 providers about their HIE buying plans, there were a few clear leaders in the field.  Providers surveyed by KLAS reviewed 38 HIE vendor offerings.  Of those, five HIE vendors were considered in more than 10 percent of the providers’ buying plans, researchers found.

If there was a clear leader, it was Medicity, which was considered in 23 percent of HIE buying decisions, according to a report from Healthcare IT News.  Next was Axolotl, with 22 percent; RelayHealth, with 16  percent; ICA, with 11 percent, and Epic, also with 11 percent. (Note: Epic was only being considered seriously when providers want to tie together multiple Epic installations.)

Looked at another way — by vendors mentioned most frequently by providers — the leaders were Axolotl, Cerner, dbMotion (part owned by the University of Pittburgh Medical Center), Epic, GE, ICA, InterSystems, Medicity, Orion and RelayHealth.

If you want to really fit the HIE to your situation, consider the following criteria, the HIN story suggests:

  • Public HIEs – A public exchange may belong to official state agencies or may be semi-independent with direct and typically temporary government backing. Public HIEs demand solutions with strong potential scalability and need standards-based technology.
  • Cooperative HIEs – In this model, otherwise-competitive hospitals work together to form independent HIE organizations, generally with an open invitation to other hospitals, clinics and physician practices. These HIEs often struggle to establish long-term funding and look for vendor solutions that offer flexible and affordable cost alternatives while best adapting diverse EMR technologies.
  • Private HIEs – In some respects, private HIEs are designed to enhance relationships as well as exchange data. Often, a single hospital or IDN creates an HIE hoping to draw in community physicians while protecting or increasing revenues. Funding is less complicated and these HIEs are more likely to be satisfied with solutions that best work with their existing technology.

The truth is, though, that whatever model best fits your HIE purchase, narrowing things down to your short-list isn’t as easy as just picking from KLAS’s top contenders.  Even these leaders have a moderate to tenuous grip on the market, and may or may not have the solution that fits your model. (Note: I’m familiar with Axolotl and Orion, both of which have what may be some of the longest-deployed tech out there, but I can’t vouch that they’re exactly better than anyone else.)

If it were me, I’d look at lesser-known, strongly-backed folks focused directly on the problem. Then, I’d do a co-development program with them so both win.  Got other ideas to share readers?