Economic disincentives, not interoperability issues, loom as the largest reason why health information exchange is struggling to gain traction in many places.

That is the conclusion of new research from the Brookings Institution. In his latest paper, Brookings fellow Niam Yaraghi challenges the idea that interoperability issues have kept doctors and medical providers from embracing HIE. Rather, Yaraghi argues it’s economic disincentives that are at fault, resulting in medical providers being less inclined to engage in HIE even as interoperability issues are resolved.

To address the interoperability problem, Yaraghi proposes a business model in which economic incentives of different entities in the healthcare market would lead them to actively engage in exchanging heath information. He outlines a business environment in which health information exchange platforms can generate substantial revenue from two sources:

*Real-time data services to different healthcare providers, and

*Asynchronous data analytics and customized reports.

According to Yaraghi, the revenue generated from these sources would be used to finance the operational costs of an interoperable heath information network.

The unique feature of the proposed model, he writes, is its self-sufficiency. To be able to operate in such a business model, the HIE platforms will furthermore not depend on federal and state financial support.

In related news, former National Coordinators for Health Information Technology speaking in a panel session on Tuesday at ONC’s Annual Meeting in Washington expressed the opinion that the main challenges for the nation’s health IT interoperability are not technical but business related.

Farzad Mostashari, M.D., former National Coordinator for HIT, warned that business practices among some electronic health records vendors are inhibiting the sharing of health information by restricting information exchange with users of other EHR products.

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