HIEs Essential in Fee-for-Value Era

Karen Minich-Pourshadi, for HealthLeaders Media , October 2, 2012

Moreover, having the clinical data when a patient presents for treatment can be a lifesaver, especially for patients visiting the island, Robertson says. With tourists coming from all over the country to Hawaii, health exchange enables HPH and other participants to link to critical data on the mainland, and helps reduce the likelihood of duplicate tests or other ancillary services, ultimately decreasing overutilization of services for participants. 

Participating in the HHIE is part of a larger effort by the state to encourage its healthcare providers to get involved with patient-centered medical homes, Robertson says, and the exchange will help track the results as these efforts get further along.

As the HIE in Hawaii picks up steam, in Cincinnati, HealthBridge, an HIE developed in 1997, is fully established in the healthcare community. HealthBridge, a nonprofit corporation, serves parts of the tristate area of Ohio, Kentucky, and Indiana. HealthBridge launched without any government funds, receiving its start-up money from investments by two health plans and five health systems. Each of these founding funders maintains a seat on the HealthBridge board of directors along with other community employers, physicians, and representatives of public health. The composition of the board has successfully allowed competitors to work through concerns surrounding data sharing, allowing for even greater adoption in the region.

"Whether to participate in HIE is a strategic conversation … but all the participants have to be willing put aside their individual issues and agenda and to work toward a solution that's best for the patient. If you treat participation in an HIE as a competitive advantage, then you won't get anywhere; but if providers get beyond their differences, then everyone can benefit from economies of scale from sharing information," says James Gravell, senior vice president and CFO at Catholic Health Partners based in Cincinnati. CHP is the largest health system in Ohio and one of the largest nonprofit health systems in the United States, with $5.4 billion in assets and 24 hospitals.

Gravell began working with HealthBridge more than 10 years ago as interim president and CEO of the three-hospital Community Mercy Health Partners and acted as HealthBridge's board chair when it was established. In the 15 years since it started, HealthBridge's HIE network has grown to more than 50 hospitals and 7,500 physicians in three states and transmits an estimated three million electronic messages per month, including clinical lab results, radiology reports, operative notes, discharge summaries, and other clinical information. The HIE connects more than 80% of physicians and acute care hospitals within its service area, and as of 2011, it estimates it has reduced healthcare costs to participants by over $20 million annually.

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