Who's Leading? How Are They Organized?
Health information exchange initiatives are continuing to formalize their operations through the creation of formal legal entities.
Health information exchange initiatives are continuing to establish legal entities to support their operations, with more than half (55 percent) having established legal corporations, 14 percent continuing to be incubated within another organization, and eight percent remaining a “loose group of collaborators”.
For those who have created a legal organization structure for their efforts, more than two-thirds (68 percent) have chosen a non-profit corporation model, while eight percent have chosen a limited liability company model, five percent have chosen a for-profit corporation model, and five percent have chosen a “virtual model”--which is not a legal entity, but an initiative formed under contractual arrangement.
Clinicians, community health centers, employers, health plans, hospitals, patients, and quality improvement organizations are most likely to play a governance role in health information exchange efforts.
For the most part, health information exchange initiatives have migrated to a model whereby multiple, diverse stakeholders are participating in the effort. Those organizations that participate in the governance of a health information exchange effort include hospitals (67%), primary care physicians (49%), health plans (43%), community health clinics (40%), local public health departments (37%), patient or consumer groups (30%), specialty care physicians (32%), employers (24%) and quality improvement organizations (21%)
Stakeholder Group |
Governance Role |
Participant |
Not Participating |
Hospitals |
67% |
71% |
4% |
Primary care physicians |
49% |
74% |
7% |
Health plans |
43% |
43% |
29% |
Community health clinics |
40% |
69% |
15% |
Local Public Health Department |
37% |
63% |
26% |
Specialty care physicians |
32% |
66% |
22% |
Patient or consumer groups |
30% |
41% |
45% |
State Public Health Department |
24% |
49% |
38% |
Employers or healthcare purchasers |
24% |
41% |
41% |
Quality Improvement Organization |
21% |
49% |
35% |
State - Governor's Office |
20% |
39% |
50% |
State - Medicaid Program |
19% |
48% |
41% |
State - IT Department |
14% |
31% |
57% |
Pharmacies |
13% |
48% |
45% |
Healthcare IT suppliers |
12% |
52% |
39% |
Independent laboratories |
10% |
46% |
47% |
State as Purchaser |
8% |
33% |
58% |
School-based clinics |
7% |
26% |
72% |
Medicare |
6% |
20% |
75% |
Independent radiology centers |
6% |
34% |
62% |
Pharmacy benefit management companies |
3% |
30% |
69% |
