Health Information Exchanges Improve EfficiencyHealth Information Exchanges Improve Efficiency

The number of health information exchange initiatives that are transmitting patient data to doctors and other stakeholders has risen from 57 in 2009 to 73 in 2010, a 28% increase, a new eHealth Initiative survey reveals.

"The State of Health Information Exchange in 2010: Connecting the Nation to Achieve Meaningful Use," was published late last month and is eHealth Initiative's latest report on the status of HIEs. Of the 234 active HIE initiatives across the country, 199 organizations responded to the annual survey. The report also noted that the number of HIEs has grown due to the establishment of 56 state designated entities (SDEs); 48 SDEs completed the survey.

The report said more organizations are reporting a reduction in staff time and redundant testing through the use of HIEs. Thirty-three respondents said that using HIEs helped them decrease staff time spent on clerical administration and filing, 30 participants said it helped them trim staff time spent on handling lab and radiology results, and 28 said they spent less money on redundant tests.

The survey also found that HIEs have increased functionality with respect to the meaningful use rules. Sixty-seven respondents said they have connectivity to electronic health records, which is a 76% increase from a year ago. Fifty participants said they can link to results delivery and 49 said they can connect to health summaries for continuity of care.

When asked about the top five types of data exchanged by the initiatives, 68 said they share laboratory results, 63 said medication data, 62 said outpatient laboratory results, 61 said allergy information, and 58 said data related to emergency department episodes or discharge summaries.

Additionally, patient engagement has increased dramatically with more organizations providing services and data access to patients through a HIE. According to the report, 44 initiatives allow patients to view their data, up from three in 2009, and 31 initiatives allow patients to contribute information on their health status, up from seven in 2009.

Initiatives are also developing measures that address security and privacy. More organizations are creating systems which allow patients to control the level of access to their information. The report's findings were that 61 initiatives have global opt-in/out policies, 36 have organizational opt-in/out policies, 34 have provider opt-in/out policies, and 14 have emergency care opt-in/out policies.

Among the challenges facing HIEs, the report said 131 initiatives cited addressing government policy mandates as a major challenge.

"In 2009, the main challenges faced were privacy, defining value, developing a sustainable business model, addressing technical aspects, addressing organization and governance issues, and engaging health plans. The challenges have not changed since 2009, aside from the concern of addressing government policy mandates. It is clear that, at the time of the survey, initiatives were very concerned about implementing the impending meaningful use regulations," the report said.

Another critical issue is the development of a successful business model, which is in the early stages of development. The report noted that while many organizations have gained the capacity to transmit data, all operational initiatives do not yet have sustainable business models.

Further, of the 107 initiatives that were not dependent on federal funding in the last fiscal year, only 18 said they broke even as a result of operational income alone.

"Hospitals and state grants are still the main source of funding for initiatives that are not state designated entities. Federal grants are a close third to state funds, but it is clear that providers in general, including hospitals and physician practices, have assumed a more significant role with respect to funding," the report said.