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.
