This second phase of the third generation of the HIE toolkit discusses developing a sustainable business model, marketing, making technical connections between data sources, and anticipating future developments like advanced data analytics, tracking progress, and shifts to cloud computing, eHI spokeswoman Genevieve Morris told InformationWeek Healthcare. The first part of the update, released in April, provides advice on setting up the governance structure for an HIE, drafting information-sharing agreements, and safeguarding patient privacy.
"Phase II of the toolkit includes essential elements for successful health information exchange," eHI CEO Jennifer Covich Bordenick, said in a statement. "Sustainability is an elusive concept; therefore HIEs needs to choose the right technical platform and appropriately market themselves to attain to be sustainable." Bordenick said that the toolkit suggests best practices for addressing future requirements.
The eHealth Initiative first released a HIE toolkit in 2006, and followed that up with a second edition two years later, incorporating best practices from 42 exchanges. Last year, an eHI survey on the state of HIE drew responses from 199 health information exchanges. This update is based on many of those findings.
Sustainability has been a particularly difficult problem for HIEs--and their predecessors, known as community health information networks (CHINs) in the 1990s and regional health information organizations (RHIOs) in the last decade. Hundreds of attempts at interoperability across health systems have failed after they burned through startup funds without developing adequate revenue streams.
"It is incredibly important that HIEs develop a sustainability plan, understand the costs they need to account for, and implement revenue streams that can cover the costs," the toolkit said. "This becomes even more important as grant funding dissipates. Successful HIEs tend to take an entrepreneurial approach to their sustainability plan and think like a for-profit business. They are continually anticipating the market and innovating their business model. When HIEs fail to take a forward-looking approach to sustainability, they risk financial stagnation."
On Tuesday, the National eHealth Collaborative, which shares a Washington, D.C., office with the eHealth Initiative, held a roundtable with HIE leaders that was webcast live. Morris said that the National eHealth Collaborative, a public-private partnership that is the outgrowth of the Bush administration's American Health Information Community advisory panel, did not specifically address the eHI toolkit during that event. But sustainability was a major topic of discussion.
The National eHealth Collaborative said it will issue a report about how successful and mature HIEs have developed. "The report is intended to capture the key dimensions of success for HIE sustainability, provide insight and guidance for emerging HIEs, and contribute to the development of a national roadmap for health information exchange," according to a statement.
The eHealth Initiative said its toolkit will continue to evolve based on experiences of and feedback from health IT leaders and HIE users at the national, state, and local levels.
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