Issues Around Financing Are the Most Pressing Challenges
The most significant challenge for health information exchange initiatives is the development of a sustainable business model.
The most significant challenge for health information exchange initiatives in 2007 was developing a sustainable business model, with more than half (56 percent) of respondents citing this as a very difficult challenge and more than one-third (35 percent) citing this as a moderately difficult challenge. Other areas identified by respondents as “very difficult challenges” included securing upfront funding (53 percent), defining the value that accrues to users (43 percent), and addressing privacy and confidentially issues (34 percent).
|
2007 |
2006 |
||||
|
Very Difficult Challenge |
Moderately Difficult Challenge |
Total |
Very Difficult Challenge |
Moderately Difficult Challenge |
Total |
Challenge |
% |
% |
|
% |
% |
|
Developing a sustainable business model |
56% |
35% |
91% |
45% |
35% |
80% |
Securing upfront funding |
53% |
27% |
80% |
57% |
33% |
90% |
Defining the value that accrues to users |
43% |
38% |
81% |
30% |
59% |
99% |
Addressing privacy and confidentiality issues |
34% |
51% |
85% |
25% |
54% |
79% |
Accurately linking patient data |
25% |
56% |
81% |
30% |
56% |
86% |
Addressing organization and governance issues |
23% |
55% |
78% |
22% |
53% |
75% |
While health information exchange initiatives continue to rely on federal and state agencies for up-front funding, the level of funding provided by hospitals is up considerably from 2006, moving ahead of the government funding as the top funding source.
In 2007, the top sources of upfront funding for health information exchange initiatives were hospitals (53 percent), federal government grants and contracts (44 percent), state government (43 percent), private payers (32 percent), and philanthropic sources (31 percent).
Start-Up Funding Source |
2007 |
2006 |
Hospitals |
53% |
24% |
Federal government grants and contracts |
44% |
42% |
State or local government grants and contracts |
43% |
29% |
Payers - private |
32% |
12% |
Philanthropic sources |
31% |
23% |
Physician practices |
17% |
8% |
Medical Societies |
11% |
N/A |
Payers - public |
10% |
7% |
Quality improvement organizations |
10% |
5% |
Purchasers and employers |
9% |
6% |
Manufacturer/vendor contributions |
7% |
12% |
Laboratories |
5% |
4% |
Pharmaceutical contributions |
5% |
4% |
Public health |
4% |
8% |
Local government grants and contracts |
3% |
N/A |
Loans from financial institutions |
2% |
5% |
Pharmacies |
2% |
1% |
Consumers |
1% |
1% |
The sources of funding for ongoing operations increasingly rely on non-governmental sources
According to the 2007 survey results, hospitals were the top funding source for ongoing operations at 61 percent, followed by the federal government (38 percent), physician practices (37 percent), private payers (37 percent), state government (35 percent), and public payers (31 percent).
