The Incremental Approach Towards HIEs

Connected healthcare is a maze of landmines to be trodden lightly. Micky Tripathi CEO of the Massachusetts eHealth Collaborative points out in his recent article, the dangers of overbuilding HIEs. Although, this is not the first attempt at healthcare information exchange (HIE) as Micky has referred to the publicized failure of Santa Barbara Care Data Exchange and the ill fate of Community Health Information Networks in the 1990s. “I’m delighted that we’re moving rapidly in this direction, but one concern keeps nagging away at the back of my mind, and that is the propensity to pursue over-architected HIE solutions”, he says.

The problem lies with the ideology of constructing a comprehensive solution that is capable of handling inter-industry information exchange, along with providing electronic support to remote clinical sites which themselves are a mere concept for now. What the government must understand is that the process cannot be sped up to reflect drastic changes and thus must follow a natural course. Incremental changes will allow the industry to respond appropriately while developing sustainable solutions that can be built from the ground up. Forcing instant change will not yield the benefits attributed to a HIE.

EMRs have been a prime example of why there is no single pill solution. Despite the rapid development in the industry, EMRs have not attained a form that could be considered complete in any regard. The world of technology is ever developing and nothing can truly be a final form. Changes are likely to occur as usability increases. While we may have a general idea of the risks associated with information sharing and health networks, actual usage will be more likely to shape a sustainable design.

The HIE infrastructure is still in its infancy whilst most practices lack the resources or adequate training to support the transition. However, it is expected for the industry to develop substantially over the next few years, with the private sector likely to lead the charge. A recent report by Chilmark Research highlighted the phenomenal growth in HIE(s) during 2011, increasing to a colossal 40% per annum.

HIEs can change the landscape of healthcare and while Accountable Care Organizations may be the initial goal; HIEs will inevitably shape a new world of care delivery.


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