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Federal Government Grant Facilitates Development of Health Information Exchanges Spring has Sprung: Will HIEs Be Coming Up Roses?

Originally published May 3, 2010

The recent federal announcement of its $547 million grant release to facilitate health information exchanges (HIEs) at the state level is like spring hitting the data exchange landscape. Fifty states and qualified state designated entities (SDEs) will be eligible to receive the funding.
The data exchange activities of the Office of National Coordinator (ONC) have been described as “a thousand flowers blooming.” While states and SDEs will have different priorities and approaches for spending their health information exchange “seed money,” the results from each one should blossom and create a perennial “garden” for consumers and healthcare providers.

As SDEs aggressively plan and launch activities, consideration of several points will help them reap benefits well into the future:

  • Engaging and aligning physicians with the value of data exchange is critical.  Like roses, careful cultivation is required. This means business processes may need to change and the value of sharing information must be readily apparent.  The incentives for adopting meaningful use of technology may help address this challenge.  The new care-delivery models initially funded in the healthcare reform bill, including patient-centered medical homes, create incentives for information sharing. 

  • Managing patient and provider identities is a crucial step, similar to tilling the soil before planting. It’s not only the accuracy of patient information that is important; it’s also true of providers’ identities. While a national provider identifier exists, it does not specify who the provider is, where he or she practices, where results should be routed or where to direct queries. Understanding a provider’s relationship to the patient may also be vital as federal and state policies address privacy and consent management.

  • Financial growth must be incorporated into planning. While the federal government is providing full funding the first year and 90% in the second year, grant recipients will need a sustainable business model that is not dependent on government financing.

  • Hosting vs. in-house software.  In upcoming months, SDEs will be tasked with defining the platform for infrastructure (i.e., VPN) and software delivery. Does the SDE have the wherewithal to manage and support infrastructure and software themselves, or will they look for a hosted subscription-based solution to reduce development costs and infrastructure investments?  In other words, does the SDE want to do its own watering and weeding, or would it rather hire a gardener?

  • Selecting a vendor with the requisite experience is a key component to success.  Integration experience and knowledge, strong product development and adherence to standards are essential.  If requirements aren’t met, delays will occur and funding requirements will increase down the road.
These options highlight the need for seeds to be sown now to help HIEs endure over the long term. Carefully nurtured, they will continue to thrive for many seasons.

SOURCE: Federal Government Grant Facilitates Development of Health Information Exchanges

  • Lorraine Fernandes
    Lorraine Fernandes, RHIA, is vice president and ambassador for Initiate Systems,  a leader in enabling healthcare organizations to strategically leverage and share critical data assets. Lorraine is a nationally known expert on electronic health records in association with regional health information organizations (RHIO), health data exchange and patient identification issues. Lorraine can be reached at lfernandes@initiatesystems.com.



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