The major operational tasks of Healtheway, according to Yeager, include testing and certifying new participants in the eHealth Exchange; helping organizations that want to join the exchange go through the required steps; supporting the exchange's infrastructure, which includes digital certificates and provider directories to share information securely; and developing legal agreements and operating policies and procedures for the exchange.
Healtheway will delegate the testing and certification function to an outside body that will be announced shortly. In coordination with the EHR-HIE Interoperability Workgroup, a consortium of 14 states that are building statewide HIEs, Healtheway has issued an RFP for an entity that will do testing for both the eHealth Exchange and the states' consortium, Yeager said. Among the companies that received the RFPs were ONC- and ANSI-accredited certification bodies, she added.
As of early 2012, what is now called the eHealth Exchange included 34 participants that represented about 500 hospitals and 3,000 providers, Yeager said. With the "dramatic growth" that the eHealth Exchange has seen recently, she noted, the number of providers exchanging information or about to go into production is much higher than that.
Among the exchange's "production participants"--entities that are already exchanging data--are four federal agencies; four states; eight Beacon communities; and about 20 healthcare systems, integrated delivery networks, and health information exchanges (HIEs), Yeager said. The federal government entities involved in the national exchange include the Centers for Medicare and Medicaid Services (CMS), the Department of Defense (DoD), the Department of Veterans Affairs (VA), and the Social Security Administration (SSA).
Until recently, most of the hospitals participating in the eHealth Exchange were involved in one of two federal programs. The VA and DoD Virtual Lifetime Electronic Record (VLER) program uses the network to exchange information between VA and military providers and private-sector providers that care for veterans and active-duty military personnel. Second, the eHealth Exchange has enabled some healthcare organizations to exchange data with the SSA to expedite the determination of eligibility for disability benefits.
Nevertheless, Healtheway forecasts a big increase in private-sector use of the eHealth Exchange in the next two years. Matthews offered these reasons:
-- The continuing expansion of the VLER program. Forty percent of veterans receive care outside the VA system, and 60% of active military personnel receive care outside DoD facilities. Private-sector physicians can greatly benefit from getting information from those facilities.
-- The ability to improve quality and lower costs by exchanging information between SSA and private providers.
-- The spread of EHR adoption and the increasing ability of physicians to retrieve data from HIEs.
-- The interoperability criteria of Meaningful Use stage 2, which will require providers to exchange more information with each other.
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