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9/18/2012
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Health Information Exchanges Struggle To Prove ROI

To survive, HIEs need to implement performance metrics to show they can improve quality of care and reduce costs.

8 Health Information Exchanges Lead The Way
8 Health Information Exchanges Lead The Way
(click image for larger for slideshow)
To convince investors that health information exchanges (HIEs) are a worthwhile investment, organizers need to develop performance metrics that show HIEs can improve quality of care and generate a return on investment (ROI). A study published in the latest issue of Perspectives in Health Information Management, however, reveals that only 50% of surveyed HIE executives say they use or plan to use metrics to measure the impact of their exchange.

Amid doubts about the sustainability of HIEs, the results of the survey are disconcerting, lead author, Anjum Khurshid, director of the health systems division at the Louisiana Public Health Institute, and his colleagues conclude, because without incorporating quality of care and ROI metrics into their business model, many HIEs may not survive.

"The transformational changes that HIEs promise come much later and require trust, evidence-based approaches, perseverance, and collaboration among all healthcare stakeholders. It would be disappointing if the already high rate of HIE failures increased in the next few years as federal funds are exhausted," the report stated.

Bill Rudman, executive director at the American Health Information Management Association (AHIMA) Foundation, told InformationWeek Healthcare that the report is a wake-up call for healthcare stakeholders.

[ Looking for a PACS platform to replace an outdated system? See 9 Must-See Picture Archiving/Communication Systems. ]

"I absolutely think it's irresponsible for healthcare provider organizations and leaders not to develop and utilize outcome metrics to measure the efficacy and efficiency of the health information exchange," Rudman said.

The report's authors note that HIEs are a key part of the Nationwide Health Information Network (NHIN) infrastructure that will electronically exchange patient data among providers in different locations. To help HIEs along, approximately $2 billion from the HITECH Act will go toward the development of HIE infrastructure and services. To help NHIN succeed, state, regional, and local HIEs must develop an effective business model that financially supports HIEs well into the future, long after these exchanges stop receiving government funds.

"This means that to convert the stimulus funding into a transformational long-term regional strategy, a case has to be made to private-sector, local, and regional stakeholders to invest in HIE initiatives. While most experts agree with the transformational potential of HIEs to support a system that delivers coordinated, affordable, and quality healthcare services, we lack robust empirical evidence of HIEs improving quality of care and providing value to patients and to participating entities," the report said.

Researchers sought to find out how many fully functional HIEs are using metrics to gauge the impact of HIEs on quality improvement and ROI. With that goal in mind, they identified 96 fully operational exchanges across the country that are transmitting data used by healthcare stakeholders, and that also have sustainable business models.

Responses were received from 21 organizations, of which 18 HIEs met the survey criteria of actually exchanging data as of January 1, 2010. Among the key findings for the 18 HIEs:

-- Fifty percent of the HIEs reported using metrics for quality improvement. Of these, most organizations tracked quality improvement in a number of different areas related to clinical outcomes and some preventive measures, including readmissions, vaccination rates, diabetes management, and cancer screening.

-- More than half of the organizations have used or plan to see reduction in duplicative tests or procedures, improved communication among providers, and improved health outcomes to measure the impact on ROI. Thirty-nine percent of respondents listed specific metrics currently being used to determine ROI. Forty percent of the organizations that were using some ROI metrics also believed more evidence was needed to show a positive impact of HIEs.

-- Ten respondents (56%) said that based on the performance of their own HIE, they believed that HIEs show positive ROI, while eight respondents (44%) felt more evidence was needed to make such a determination. Two respondents who believed HIEs show positive ROI stated that they have not used metrics to calculate ROI but are in the process of developing ROI metrics. Seventeen respondents (94%) believed that HIEs improve quality of care.

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)

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Ruby Raley
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Ruby Raley,
User Rank: Apprentice
9/24/2012 | 6:23:57 PM
re: Health Information Exchanges Struggle To Prove ROI
For HIEs to be successful in the long run, organizations need to develop effective business plans that prove HIEs are a worthwhile investment. The value gained from implementing an HIE can only be determined by the community, as they are the ones who will decide how to utilize HIEs so that they do in fact improve the quality of healthcare. The transformation of HIEs happens progressively, but coordinating and supporting a key network early is valuable in ensuring the HIE is successful. Utilizing best practices from existing HIEs -- such as early and frequent communication within the community and the development of companion guides for documents being exchanged -- will not only help improve the success rate, but ultimately help improve ROI.

More on this topic: http://blogs.axway.com/2012/09...

Ruby Raley, Director, Healthcare Solutions, Axway
jaysimmons
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jaysimmons,
User Rank: Apprentice
9/23/2012 | 12:50:48 AM
re: Health Information Exchanges Struggle To Prove ROI
What a truly disheartening study. What is the point of an HIE if not to improve quality of care, ROI, and reduction in duplicate tests? HIEs are in their infancy and must prove their worth if they are ever going to take off or even be sustainable. I hope that the 50% who don't plan on doing anything get a wake up call. Funding should be tied to these metrics!
Jay Simmons
Information Week Contributor
Big Love for Big Data? The Remedy for Healthcare Quality Improvements
Big Love for Big Data? The Remedy for Healthcare Quality Improvements
Healthcare data is nothing new, but yet, why do healthcare improvements from quantifiable data seem almost rare today? Healthcare administrators have a wealth of data accessible to them but aren't sure how much of that data is usable or even correct.
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