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What it Takes to Make a Sustainable HIE

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The fundamental beauty of health information exchanges (HIEs) is that they allow clinicians and patients to have secure access to patient data across disparate healthcare systems. Their benefits are numerous, yet HIEs still face various obstacles in 2021.

Today, most state and regional HIEs are not connected to other networks—only those in their immediate region. This lack of connection occurs for various reasons, but mainly because different states have different rules for information sharing. In addition, vendors are consolidating with payers or other data warehouse offerings in the market, and most state HIEs were formed with grants and funding streams that have started to run their course.

With the continued shift from fee-for-service to value-based care and the sunset of Meaningful Use, HIEs must quickly establish themselves as self-sustaining organizations with real business value. Vendors must also deliver more than just the basics in a timely, cost-effective, and standards-based way for HIEs to continue to exist and benefit the consumer.

The Emergence of TEFCA in 2022

On July 13th, the ONC released the timeline for the rollout of the Trusted Exchange Framework and Common Agreement (TEFCA). TEFCA is a promise from the 21st Century Cures Act that aims to establish “a floor of universal interoperability across the country.” The framework coincides with the Common Agreement, also a component of the Cures Act, to offer a standardized, secure infrastructure model for organizations to share clinical data.

Healthcare providers, patients, payers, state agencies, and others can use the various requirements of TEFCA to send and receive electronic health information. These stakeholders should determine to what degree they will participate in TEFCA now as it is officially underway. Furthermore, HIEs should consider the potential benefits of becoming a QHIN (Qualified Health Information Network). While the requirements to qualify as a QHIN are evolving, HIEs should consider whether they can achieve such designation and if it is the appropriate strategy for their model. True HIE sustainability means keeping up with the ever-evolving industry, standards, and framework that continue to be created.

Qualities of the Ideal HIE Vendor

Adoption must be supported by a vendor who can deliver timely and affordable interfaces while also supporting a workflow back into the EMR. Simply adding another clinical portal does not drive adoption. Many vendors claim they can deliver standards-based interfaces and parse CDAs promptly, only to fall short. A genuinely seamless workflow directly into the EMR with only the information you need on the patient is a golden standard we all wish to obtain, and it does exist.

HIEs need to present actionable insights at the point of care, which often requires more than just parsed clinical data from a clinical data repository in a web-based portal. Having a holistic view of patient data results in better-coordinated care, improved quality, and reduced costs while feeding into analytics and reporting tools to support quality coverage for a population.

As mentioned above, HIEs should also stay informed of national strategies and industry movements. Ensuring compliance with the latest standards and regulations is a high priority, and any updates to information blocking, TEFCA, QHINS, and more should be considered to guarantee the long-term success of modern HIEs.

This vigilance will provide high fidelity, regional exchange, and participation for HIEs in key nationwide agreements for the broader, seamless movement of electronic health information.

Come to Lightbeam’s Guest Speaking Session at HIMSS21

Lightbeam frequently discusses the Cures Act on the blog and co-hosted a webinar presentation with former ONC National Coordinator for Health Information Technology, Dr. Don Rucker, last year. At HIMSS21, Lightbeam is thrilled to share that Dr. Rucker will co-host a Lightning Session on the 21st Century Cures Act, interoperability, and information blocking alongside Chief Medical Officer of Lightbeam, Dr. Kent Locklear. For more information, visit the session page.

Carrie Roth is Lightbeam’s AVP of the HIE Market.

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