The Office of the National Coordinator for Health IT (ONC) is striving to meet the many challenges posed by the adoption of health information exchanges (HIE).

“We’re on the verge of turning the corner on HIE,” said ONC director Claudia Williams during a recent webinar.

“The building blocks put in place by the HITECH Act help everyone see where exchange fits into the broader set of goals we all share. We’ve made incredible progress is a short amount of time. Information exchange should take off in 2012.”

Just what challenges are facing HIE adoption and expansion? An article published in the April edition of the Journal of the American Medical Association, listed several significant obstacles that must be overcome by the healthcare industry for HIEs to be realized.

In the article, authors Julia Adler-Milstein of University of Michigan in Ann Arbor, and Ashish H. Jha, of the Harvard School of Public Health in Boston said privacy and security are the primary concern for HIE stakeholders.

“There remains uncertainty among clinicians about the legal ramifications of a data breach or unauthorized access through HIE,” the authors wrote.

Another major cause of concern for providers is the potential negative impact that sharing healthcare data could have on their business.

“(P)hysicians and hospitals are concerned about the competitive implications of sharing their data, which may make it easier for patients to seek care from rival institutions. Hospitals view clinical data as ‘a key strategic asset, tying physicians and patients to their organization,’” the article said.

The authors also said HIEs would change physicians’ culture and workflow by making them responsible for sifting through a patient’s medical history before prescribing treatment. Currently, providers must make decisions with less comprehensive medical records.

Policy makers could take several steps to help overcome these obstacles, according to the article. Clear and severe consequences for perpetrators of data breaches would give stakeholder greater comfort with respect to security. In addition, incentives must be created by Medicare and Medicaid for providers who are willing to share health information.

For its part, the ONC will be focused this year on several key areas concerning the adoption and expansion of HIEs: more rigorous exchange coordination requirements, establishment of more standards, oversight of the Nationwide Health Information Network (NwHIN), and expand state HIE programs.

One of the ONC’s strategies for 2012 will be building on the foundation laid by the Meaningful Use Stage 2 guidelines released earlier this year. The agency will focus on the Stage 2 rules in an attempt to better coordinate the HIEs.

“(The MU Stage 2 rules) sets the stage for the kind of rapid progress and exchange we need and what we want to see over the next couple of years,” according to director Williams.

In addition to focusing on building guidelines and establishing standards, the ONC will also look to refine the bureaucracy in place at both the national and state level. According to Williams, the lack of national HIE structural leadership has caused individual states to adopt their own bureaucracies.

“We’d much rather have national guidance and put in place conditions that allow for a competitive marketplace, just as with EHRs,” Williams said. “There are a wide variety of strategies depending on what’s already in place and what kind of rapid progress is possible in a particular area.”