With the health care IT market currently in a state of rapid growth and change, a new focus is being placed on the pressures and opportunities faced by companies and organizations who are invested in the coordinated sharing of information among providers, insurers, and ultimately patients across a common network.
In his recent HIMSS12 keynote speech on patient-centered care and Accountable Healthcare Organizations (ACO), Dr. Antonio Linares, RVP and Medical Director at WellPoint, said “ACOs will ultimately require us to transfer data bi-directionally in real-time from provider to health plan.”
This type of data transfer is already achieved through what is being called a Health Information Exchange (HIE). According to the HIMSS website, an HIE “involves multi-directional flows of information electronically between providers (hospitals, physicians, clinics, labs) and other sources of administrative or clinical information provided by consumers, health plans, employers, local, state or national organizations.”
The impetus for the recent development of HIEs was put in place by the American Reinvestment and Recovery Act of 2009, which set aside $300 million for grants to states that can demonstrate a readiness to develop these exchanges. The states will look to interconnect regional health information organizations (RHIO) and allow them to share all type of health care information safely and securely.
How fully realized HIE will function is still being developed, but HIMSS describes a multi-layered collection of “services”. These services will allow access to the exchange from either a clinical or business perspective and would accomplish this through “physician Web portals, PHRs, clinical messaging, clinical interoperability and exchange of data from electronic medical records.”
Companies have begun to position themselves in an attempt to capitalize on the increased demand, via mandated governmental pressure, for networks capable of providing for this type of data exchange. On Tuesday, Highmark Inc. announced a partnership with Verizon to develop Pennsylvania’s first state-wide “IT platform that enables the sharing of patient information across multiple health care systems.”
Highmark, the state’s largest insurer, released a statement saying patients “will soon benefit from fewer duplicative diagnostic tests, faster retrieval of clinical information, stronger safety measures and better coordination of care.”
Currently, there are several RHIOs in Pennsylvania allowing for the longitudinal flow of health care data but none will match the size and scope of the state-wide network being planned by these two companies. These smaller RHIOs could join with the Verizon-Highmark network in the future, creating an even more comprehensive association.
The dream of fully operational and interconnected information exchanges across the country is still far from being realized. Many of the current RHIOs in place are not Meaningful Use Stage 1 certified, according to a recent study published by the Annuals of Internal Medicine.
The study, published in May of 2011 and performed by a group mostly from Harvard University, showed that 13 out of 179 RHIOs “supported stage 1 meaningful use (covering 3% of hospitals and 0.9% of practices).”
It also noted that 75 of 179 RHIO respondent organizations were “operational” and 50 out of those 75 (67%) “did not meet the criteria for financial viability.”
Authors of the study questioned the self-sustainability and effectiveness of RHIOs in their current state.