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Public HIEs Failing, Poll Says
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Lorna Garey
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Lorna Garey,
User Rank: Author
1/31/2014 | 10:42:34 AM
Old advice applies
This isn't rocket science. IT's been doing the standard vs. proprietary dance since the mainframe era. Private (read: proprietary) HIEs have better functionality. Oh yeah? They should. They also will bite you in the ass eventually. One would hope HC IT pros have enough sense to demand some connectivity standards, at the very least. 
David F. Carr
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David F. Carr,
User Rank: Author
1/31/2014 | 6:28:31 PM
Re: Old advice applies
As far as I understand it, private HIEs are not necessarily more oriented toward proprietary data standards -- they're proprietary in the sense of being owned and operated by a particular healthcare organization, rather than some neutral nonprofit. So this isn't really about standards but openness.

Readers: correct me if I'm wrong.

What I hear from hospital CIOs is that they feel they need to establish their own private infrastructure because the public HIEs are either disfunctional or absent in the regions where they operate.

Also: interesting comment I heard from today is that HIEs are supposed to be about transparency, but one of the other rising trends -- the creation of Accountable Care Organizations where pay for value replaces pay for service -- runs directly contrary to that. Sharp Healthcare CIO Bill Spooner told me, "ACOs are competitive organizations" -- competitive organizations being encouraged by the federal government to improve quality and lower costs, but still competitive structures because you're trying to prove that your ACO can do a better job of delivering high quality for low cost. You do that with data, which means you're competing partly on complete, high-quality data, which may make healthcare organizations less eager to share. That may be shortsighted to the extent that everyone would have better, more complete data if the data sharing infrastructure was there, but it shows the kind of political complications and conflicts that can arrive when regulatory initiatives collide.


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