The nation's healthcare providers are digitizing loads of information about their patients. But all that effort will be of limited use if the data can't be shared easily and securely. Enter health information exchanges--organizations that are creating networks to let hospitals, doctors' practices, labs, and other healthcare providers exchange data securely with the ultimate aim of providing physicians and other caregivers more up-to-date and comprehensive patient data to improve care and cut costs.
HIEs vary in scope. Some merely link all the doctors in one hospital system to one another, as well as to independent labs and other outside facilities. Others have broader mandates to let doctors share data with colleagues in other hospital systems locally, regionally, and nationally.
Generally, HIEs provide electronic referrals, clinical messaging, public health surveillance, insurance eligibility, e-prescribing, and other services. Some exchanges operate a centralized data repository, requiring them to have their own infrastructure of servers and data centers. Others HIEs use decentralized data models and serve as less of a central hub, instead playing a traffic-cop role, coordinating the data-sharing, governance, and security policies the organization needs to function.
HIEs face a range of challenges as they try to get hundreds and even thousands of participants sharing data. Chief among them is the need to fund their efforts after their initial grant money runs out. Failure to come up with a sustaining financial model has doomed regional data-sharing organizations in the past; participants often don't see the value in funding the exchanges out of their own pockets once the initial support dries up.
For HIEs to succeed, "healthcare providers need to see the value in what they're paying for," says Micky Tripathi, president and CEO of the Massachusetts eHealth Collaborative, a nonprofit group that has helped create several regional HIEs. And that means HIEs must prove up front to participants that they're worth paying for. To do that, they have to quickly overcome many technical challenges--everything from choosing the right data-sharing platform to determining the best way for clinicians to view data to ensuring that patient data is secure.