Population Health, Value-Based Care Drive Health Information Exchanges

The pursuit of population health and value-based care "may be reviving the business case for organizations to join health information exchanges," according to a HealthLeaders magazine article. Now more than ever, providers need accurate and complete patient data to effectively manage chronic care populations and earn incentives or shared savings; they need their own data as well as that of their affiliates and competitors. Bringing down costs in the health care system as a whole depends on sharing data. Nevertheless, although preliminary results suggest HIEs can help health care organizations save money, some are still reluctant to participate.

An HIE is an organized regional network that enables hospitals, physicians, and other care providers to upload and access patient health information. HIEs connect data for organizations—from affiliates to competitors—to share clinical data that can improve a patient's overall care. The HIE is generally connected through a provider portal, giving easy access to clinical applications that allow caregivers to see all of the patient's clinical information in real time while restricting access to any claims data or other financial information. Early data indicates the HIE can reduce costs for participants. But one of the main barriers to participation may be issues associated with costs; and not just the actual dollar amounts required to make the investment, but who makes the investment and who controls the flow of capital. Whether to participate in HIE is a strategic conversation, but all the participants have to be willing put aside their individual issues and agenda and to work toward a solution that's best for the patient.

Although the American Recovery and Reinvestment Act (ARRA) allotted grants to encourage the establishment of HIEs, participating in an HIE still doesn't come free. Participants must have an EHR in place, and most HIEs ask participants to pay a fee to connect; that price can vary depending on an organization's size and the degree and complexity of the connectivity needed. Employers have a unique role to play as purchasers in the encouragement of HIE establishment because employers all need employees whose health conditions are well-managed. HIE establishment presents a unique opportunity for employers to partner with and work directly with providers.