A large survey of health care providers and payers during the last six months of 2013 finds considerable skepticism of the future of health information exchanges.

Black Book polled 1,550 providers and 794 payers using HIE, and the results are sobering. Ninety-five percent of payers, 83 percent of hospitals and 70 percent of physicians responded that publicly-funded HIEs are struggling with flawed business models and are not providing meaningful connectivity. Polled organizations were users of public or private operational exchanges.

Seventy-two percent of respondents believe that by 2017, there could be as little as 10 of the currently functioning public HIEs supported by federal grants that are ending, unless they find better business models, improve their processes and create ways to encourage participation. Nearly all health care organizations believe community/regional and private HIEs are better suited to meet their needs.

The HITECH Act funded more than a half-billion dollars for state HIEs but 94 percent of surveyed payers don’t see the value proposition in these entities. Less than a third of the payers are participating in public HIEs and 86 percent reject paying the annual fees despite expected benefits of reducing costs by cutting duplicate tests and procedures, reducing readmissions and identifying population health trends. Nearly all payer respondents say public HIEs are struggling to exchange data between payers and providers, according to Black Book.

Most surveyed providers and payers agree that the payers can fill information gaps for providers, but providers are not yet benefitting financially with HIE. More than 80 percent of all respondents believe a national operational public HIE is at least 10 years away. One third of surveyed multi-provider networks and hospital systems are considering private HIEs to better standardize sharing of data. Virtually all surveyed providers think payers should reward providers for using HIE that leads to reduced costs and improved care.

Black Book also asked survey respondents about the performance of private HIE vendors. The top five vendors in specific categories were: Covisint (payer-centric), ICA (core HIE systems), Infor (complex data & multi-organizational), Cerner (inpatient EHR/HIE) and dbMotion from Allscripts (ambulatory EHR/HIE).

A complete report on the 2014 Black Book HIE survey results is available here; the cost is $2,495 for a single use license.

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