Health information exchange survey reveals interesting trends
CHICAGO—Most operational health information exchanges (HIEs), although created independently of one another, demonstrate a number of similar structures and goals, according to responses received by the Healthcare Information and Management Systems Society (HIMSS) HIE Common Practices Survey. HIMSS conducted the survey in late 2008 to gain insight into the common practices of HIEs.
Of the 21 HIEs participating in the survey, 90 percent are non-profit and all of the participating HIEs had been exchanging healthcare information for at least six months. Although the exact number of operational HIEs has not been clearly identified in the industry, these 21 participating HIEs are thought to represent a significant number of HIEs when the survey was administered in 2008, HIMSS said.
"The survey results confirmed similarities among these 21 HIEs," said Carla Smith, executive vice president, HIMSS. She explained that all of the respondents rely on a membership model to sustain funding while 61 percent depend on grants and contracts to maintain long-term sustainability.
The report is based on self-reported information which resulted in identification of several interesting trends warranting future research in a more formalized research environment. Select primary findings include:
Belief in uniqueness--Even though the HIE organizations surveyed are similar in purpose and formation, it appears that most did not follow a model or guide during formation. This was due to a belief in the uniqueness of their resources, regions and charter. Nevertheless, the survey results indicate several commonalities in both administrative and technical areas that could be worthy of further in-depth research.
Physicians, health system primary stakeholders--The stakeholders that are initially and currently engaged at most HIEs appeared to be health systems, primary care physicians and specialty care physicians.
Membership model linked to sustainable funding--All of the respondents who indicated having sustainable funding use a membership model.
Government grants/other funding key to survival--Sixty one percent of survey participants expressed a dependency on grants and contracts for long-term sustainability.
Buy rather than build--Seventy one percent of the respondents stated that their HIE chose to buy rather than build the actual technical exchange and its primary applications.
Vendor-hosted exchanges predominant--Seventy one percent of the respondents have data exchange activities operating from a hosted source rather than at their own facilities. Most respondents appear to use the primary vendor as the hosted source.
Service-oriented architectures common--Service-oriented architecture (SOA) is used by 61 percent of the respondents.
HIEs support common standards--Most of the responding participants support one or more common health industry data standards such as: ICD-9, CPT-4, LOINC-1 and NDC while 90 percent of the respondents support HL/7 messaging standards.
Lab results, prescriptions top functions--Data most often exchanged for inpatient, outpatient and physician practice office include lab results and prescriptions. Clinical patient notes and documentation are also noted in the survey as being exchanged between inpatient and outpatient settings.
Opt-in, opt-out provisions common--Sixty percent of the HIE respondents allow for patient opt-in or opt-out.
Interoperability with other HIEs--Eighty five percent of the participants indicated they have considered interoperability with other HIE organizations at the state or federal level.
"These trends, and others, provided valuable insight into the technical realities of HIEs," noted Smith.
Of the 21 HIEs participating in the survey, 90 percent are non-profit and all of the participating HIEs had been exchanging healthcare information for at least six months. Although the exact number of operational HIEs has not been clearly identified in the industry, these 21 participating HIEs are thought to represent a significant number of HIEs when the survey was administered in 2008, HIMSS said.
"The survey results confirmed similarities among these 21 HIEs," said Carla Smith, executive vice president, HIMSS. She explained that all of the respondents rely on a membership model to sustain funding while 61 percent depend on grants and contracts to maintain long-term sustainability.
The report is based on self-reported information which resulted in identification of several interesting trends warranting future research in a more formalized research environment. Select primary findings include:
Belief in uniqueness--Even though the HIE organizations surveyed are similar in purpose and formation, it appears that most did not follow a model or guide during formation. This was due to a belief in the uniqueness of their resources, regions and charter. Nevertheless, the survey results indicate several commonalities in both administrative and technical areas that could be worthy of further in-depth research.
Physicians, health system primary stakeholders--The stakeholders that are initially and currently engaged at most HIEs appeared to be health systems, primary care physicians and specialty care physicians.
Membership model linked to sustainable funding--All of the respondents who indicated having sustainable funding use a membership model.
Government grants/other funding key to survival--Sixty one percent of survey participants expressed a dependency on grants and contracts for long-term sustainability.
Buy rather than build--Seventy one percent of the respondents stated that their HIE chose to buy rather than build the actual technical exchange and its primary applications.
Vendor-hosted exchanges predominant--Seventy one percent of the respondents have data exchange activities operating from a hosted source rather than at their own facilities. Most respondents appear to use the primary vendor as the hosted source.
Service-oriented architectures common--Service-oriented architecture (SOA) is used by 61 percent of the respondents.
HIEs support common standards--Most of the responding participants support one or more common health industry data standards such as: ICD-9, CPT-4, LOINC-1 and NDC while 90 percent of the respondents support HL/7 messaging standards.
Lab results, prescriptions top functions--Data most often exchanged for inpatient, outpatient and physician practice office include lab results and prescriptions. Clinical patient notes and documentation are also noted in the survey as being exchanged between inpatient and outpatient settings.
Opt-in, opt-out provisions common--Sixty percent of the HIE respondents allow for patient opt-in or opt-out.
Interoperability with other HIEs--Eighty five percent of the participants indicated they have considered interoperability with other HIE organizations at the state or federal level.
"These trends, and others, provided valuable insight into the technical realities of HIEs," noted Smith.