Breakthrough Health Information Exchange Research and Sustainability Tools Released by eHealth Initiative Foundation
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June 5, 2007 |
Breakthrough Health Information Exchange Research and Sustainability Tools Released by eHealth Initiative Foundation
Findings Point to Importance of Social Capital, Business Practice and Customized Local Sustainability Solutions
WASHINGTON June 5, 2007 As a capstone to four years of federally-supported work on community electronic health information exchange (HIE), today the eHealth Initiative Foundation (FeHI) debuted study findings and a Value and Sustainability Model (VSM) that will irrevocably transform the way HIE is understood and practiced. Collectively, these resources highlight that HIE sustainability is possible and, ultimately, the key to building a Nationwide Health Information Network (NHIN) from the ground up. This work was conducted in conjunction with eHI's Connecting Communities program through a cooperative agreement with the Health Resources and Services Administration Office for the Advancement of Telehealth (HRSA/OAT) and involved a team of recognized health care, economics, and financial modeling experts
The eHI Value and Sustainability Model and tools are designed to assist communities in conceptualizing and developing sustainable HIE initiatives. They leverage the very latest lessons learned from eHI's extensive review of community-level health information exchange. Because no two communities are alike, VSM tools are adaptive and able to be used as a whole or in component parts. eHIs Chief Executive Officer, Janet Marchibroda, said of the VSM, our work in the HIE field revealed that sustainable business model development is one of the greatest HIE challenges. eHIs Value and Sustainability Model offers a solution that is based squarely on the lessons of those who have gone before, customized to each communitys needs. It is a true breakthrough that comes at a critical time. Three community HIEs participated in the development of the VSM tools: the Indiana Health Information Exchange in Indianapolis, HealthBridge in Cincinnati and Taconic Health Information Network and Community in Fishkill, New York.
The VSM is comprised of four tools including: (1) a market readiness assessment tool; (2) a tool estimating the value created by any HIE network; (3) an estimator of risk involving investors, community HIE returns and level of HIE subsidization; and (4) a business plan pro forma, complete with interactive HIE financial statements. These tools are publicly available on the eHI Connecting Communities toolkit site at: http://toolkit.ehealthinitiative.org/. Registration is required. FeHI can also offer supplemental technical assistance at a reasonable cost to aid communities in using and gaining full value from the VSM tools.
Important new research study findings were released in tandem with the VSM and are an evaluative look at eHIs Connecting Communities work. The key findings that highlight whats working in HIE today and whats needed for sustainability tomorrow are:
Sustainable HIEs are possible and can support a convergence towards the Nationwide Health Information Network HIE sustainability, while not easy is possible, yet there is no silver bullet or one-size-fits-all solution. Successful HIE organizations view themselves as accountable business managers, not as philanthropies or social utility enterprises. They articulate and demonstrate clearly how the HIE provides gains in efficiency and/or effectiveness using proven metrics.
Franchising models where successful pioneer HIEs may sell their experience, expertise and technology to emerging HIEs are occurring and could be a model for accelerating the adoption of interoperable exchange at lower costs for start-up HIEs, and supporting broader HIE sustainability.
The pathway for the NHIN lies with community-based HIEs organized around medical trading areas adapted to local communities, finding creative revenue models and developing new social capital that reshapes the configuration of health care institutions.
Building social and human capital is vital to HIE value, success and sustainability The foundation of any HIE is building social capital a radius of trust and goodwill among competing and disparate stakeholders who want to initiate an exchange. Likewise, human capital a committed, charismatic HIE management team that skillfully manages capital, builds consensus across stakeholders and executes critical functions such as finance, compliance and marketing enables an HIE and paves the pathway to sustainability.
Increasing HIE functionality = more value and market transformation The study identifies two stages of HIE functionality, Stage 1 Transaction Models involving transaction processing and basic exchange capabilities and Stage 2 Infomediary Models, representing more advanced exchange functionality in which value accrues from HIES acting as infomediaries, aggregating patient care data that is sought not only by providers but also by other data users regionally and nationally. These can include public health agencies, payers, purchasers, life science researchers, pharmaceutical and medical device/technology manufacturers and third-party application vendors. HIEs of the future can and likely will evolve to act as clinical data and information intermediaries. As HIEs move from Stage 1 to Stage 2 and create an increasingly robust platform of information that facilitates improved efficiency and clinical and service quality, the opportunity to create and provide value increases dramatically. Transformative leaps in outcomes reporting, care coordination and cost-transparency, for example, would then be possible.
Federal governments role in supporting HIE The Federal government should play an active role in supporting HIEs by providing staged start-up funds tied to specific performance obligations and working to reform the reimbursement system so that incentives for adopting HIT and HIE in particular, reduce or eliminate current financial and institutional barriers.
eHIs Value and Sustainability Model and the research findings released today are just two useful products resulting from the eHealth Foundations Connecting Communities collaboration with HRSA/OAT which Director Dena Puskin, ScD said has advanced health information exchange immeasurably across America and is a model of fruitful collaboration between the public and private sectors.
For more information on this research, eHIs VSM and its Connecting Communities program, go to http://toolkit.ehealthinitiative.org/value_creation_and_financing/VSMhome.mspx.
Registration to the Connecting Communities Toolkit is required.
About eHealth Initiative (eHI) and its Foundation
The eHealth Initiative and its Foundation are independent, non-profit affiliated organizations whose missions are the same: to drive improvements in the quality, safety, and efficiency of health care through information and information technology.
eHI engages multiple stakeholders, including clinicians, consumer and patient groups, employers, health plans, health care IT suppliers, hospitals and other providers, laboratories, pharmaceutical and medical device manufacturers, pharmacies, public health, and public sector agencies, as well as its growing coalition of more than 280 state, regional and community-based collaboratives focused on improving health care by mobilizing health information electronically, to develop and disseminate common principles, policies and best practices for improving the quality, safety and effectiveness of America's health care through information and information technology.
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