As a senior leader in at least six health information technology companies over the years, Nancy Ham has seen a lot of change in the industry. Now CEO of health information exchange vendor Medicity, she, as well as leaders of other HIE firms, are dealing with rapid change again.

HIE vendors historically aided information exchange by transmitting Health Level Seven messages among stakeholders and later becoming a conduit for transmitting documents using the Continuity of Care and Consolidated-Clinical Document Architecture formats.

Summaries of care have been the general rule in HIE with little exchange of discrete data elements. Now, the emerging Fast Healthcare Interoperability Resources standard to query and retrieve specific data elements has the potential to bring new business opportunities to Medicity and its competitors, who participate in workgroups to finalize the standard.

Also See: Coexistence of FHIR, C-CDA Seen Easing Interoperability Problems

A big change in the past year has been higher interest among health insurers for better connectivity with providers, Ham says. Some payers today are using HIE vendors to send physicians clinical alerts when a patient has been admitted to the emergency department or hospital, and payers also are working more closely with provider care managers. Insurers can contribute historical data to providers; some Medicaid agencies, for instance, are sending medication histories to providers.

Ham acknowledges that health information exchanges have had a rough road, with many regional and state HIEs no longer in business. But in many other areas, HIE is working very well, she adds. And with the emergence of accountable care and value-based reimbursement, there is now a higher business need for HIE among providers and payers entering into risk-based agreements.

Accountable care also has spurred health information exchange vendors to expand their services. Medicity’s expanded product line now includes cost/utilization/physician score cards supported with data analytics, clinical analytics, and tools to support population health management, care plans, registries, gaps in care, medication histories, patient access, clinical alerts, and secure messaging and referrals.

The company’s technology powers health information exchanges in 12 regions and nine states, with 250,000 users and more than a billion annual clinical transactions. It also is seeing large growth in private HIEs, Ham says, such as working with more than 100 hospitals building networks linking clinicians to support population health.

So, Ham says, rumors of the death of health information exchanges are greatly exaggerated.

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