"As we roll toward ACOs, we're going to see more providers having to contract with some sort of entity, and there's a financial risk involved. The better the performance you have and can show proof of, the better rewarded providers will be financially," says Snell. "Over 2,500 primary care providers in Central Indiana receive reports through IHIE's Quality Health First program and they can see how they compare with their peers on prevention and chronic disease management. That also ties to the financial incentives that hospitals and payers have with providers—if they hit their quality marks, that can add up to significant dollars. And that's beginning to help us see significant improvements in the quality indicators for those participating providers. Now we have the whole medical community moving toward pay-for-value and away from
pay-for-service," explains Snell.
Snell says that Indiana has come a long way from when it started its HIE and now has five, noting that the issue of working with competitors was a very real one when it began.
"You have to work with your competitors because patients are going to expect providers to be able to access their clinical information wherever they happen to be, and not being able to do so will become a competitive disadvantage," says Snell.
With the majority of HIE organizations, governance is coming from the participants, [so] it's unlikely that the "wrong" information will get shared, Snell says. "HIE isn't a Wild West–type of business; health information is tightly regulated through HIPAA and state laws, and maintaining business security and confidentiality of that information is paramount for our participants," says John Kansky, vice president of strategy and planning for IHIE. "We have very detailed data usage agreements that reference the powers of our governance body. If we come up with an idea for how to use data, the governance body has to approve it before we can pursue it."
Though regional HIE networks are the first step for many healthcare organizations, the future of HIEs lies in eventually linking all HIE networks nationwide. But before healthcare can achieve this goal healthcare leaders must make a clinical and financial leap of faith by working with competitors, says Gravell.
"For CHP, HIE is something we are looking at for every community we're involved in," he says. "We feel strongly that from both a financial and IT perspective using HIE is a more cost-effective way to move information, and having access to that information in real-time is the right thing to do for our patients."
This article appears in the September 2012 issue of HealthLeaders magazine.