Health information exchanges must produce a return on investment that goes hand in hand with meaningful use as well as reliable patient data in order to increase provider HIE adoption. The recent Black Book HIE survey highlighted a shift from volume to value within the health care industry and showed how this shift has pushed physicians to start investing in HIEs differently.
What value does the health care industry place on HIE?
The survey takes a close look at responses from more than 4,000 HIE clients and potential customers during the period between the second and final quarters of 2014. The results are also based off of the findings from another survey including 1,290 health care insurers, payers and industry organizations.
As a means to address standardizing the sharing of patient information among their organizations, close to 60 percent of multiprovider networks and hospital systems expressed intentions of investing in HIEs that were designed to better cater to interoperability. Almost all of the respondents – 93 percent – believe that the main cause of poor interoperability between payers and providers is an insufficient number of financial drivers and regulatory demands. This figure comes even after gains in HIE rose to 69 percent over the last two years.
Nearly all of the survey's health care organizations and providers working as accountable care organizations reported that they place value over volume when it comes to their HIEs and have their sights on systems that can achieve the aims of value-based care models. Trusted patient data sets are valued by over 90 percent of physicians. However, almost 70 percent feel that they are unable to trust the patient data that is delivered to them from HIEs.
"The HIE market will dramatically change during the next two years as providers seek electronic health records systems that support data exchange to qualify for meaningful use incentives," said the authors of the report, according to EHR Intelligence. "As HIEs consolidate, it is vital that they keep and cultivate the confidence of their original stakeholders by involving them in the operational progression. The key challenge for consolidating HIEs will be to maintain the stakeholder trust that has taken extraordinary efforts to develop."
According to EHR Intelligence, many physicians believe that their patient records are inaccurate or are missing information after they have been exchanged electronically using HIEs. This is why it is important for providers to invest in a trusted HIE that reduces the likelihood of unreliable patient data. A system model that positions the HIE to meet the needs of accountable care and is based on a shared vision among stakeholders is key to successful delivery of patient records.
The future of HIE expansion and spending
As EHR adoption and HIEs are closely tied, the more physicians who adopt EHR systems, the more success they have at achieving HIE readiness. The Black Book survey showed that physician groups consisting of more than 10 physicians are most likely to adopt HIEs based on their EHR adoption rates. Only 39.1 percent of practices with one physician are poised for HIE adoption. This number jumps to 73.2 percent for practices with 10 to 19 working practitioners. A total of 95.8 percent of groups with 50 or more physicians are set to adopt HIE.
The lack of interoperability has proven an obstacle for many providers with inefficient EHR systems. In fact, 67 percent have reported in the survey that they feel interoperability has gotten in the way of improving patient care. However, this is a 20 percent decrease from 2013, when 87 percent found interoperability to be a challenge.
Over the next three years, multispecialty practices will rely on help from integrated delivery networks, academic medical centers and health systems to increase their spending commitment to HIEs. The majority of practices also intend to increase their HIE spending over the next several months, foreseeing a 100 percent rise in 2016 until it declines to 92 percent the following year. Academic medical centers and health systems, on the other hand, will have a drastic decrease in HIE spending by 2017.
One of the most essential aspects of HIE for 90 percent of physicians is meeting meaningful use standards and return on investment goals. Compared to the other three goals, this was by far the most widely sought after. Only 22 percent valued HIE to improve eligible and disability determination, 23 percent sought it to enhance performance on risk contracts and 35 percent were looking for a turnaround of ancillary results.
Other factors that physicians focus on are whether HIEs are in their advanced state of operations, have sufficient pilot stages and are presently transferring information through stakeholders. The ability of HIEs to support quality reporting and data analytics and to be independent of government funding are also crucial to a sustainable HIE. However, only 10 percent said that they felt patient access to health records and data were important.