An annual survey of health information exchanges has identified 255 such initiatives in 2011, up 9 percent from 234 a year ago.
But only 24, or about 9.6 percent, of such initiatives report having sustainable business models, which is a slight improvement over the 7.6 percent reporting sustainability in 2010.
Further, many of the HIEs are concentrated with 110--or 43 percent--in just 10 states.
For instance, two populous states that are vastly different in size have roughly the same number of HIEs. New Jersey, ranked 47th in size but 9th in population has 9 HIEs, while California ranked third in size and first in population has 10. New York and Texas each have 17 HIEs. The other top 10 states are Florida (12), Michigan (10), North Carolina (9), Ohio (9), Washington (9) and Oklahoma (8).
Washington-based eHealth Initiative conducted the survey, which shows 85 HIEs are operational compared with 73 a year ago. Other findings include:
* Ten HIEs that participated in last year's survey are gone: 4 consolidated into other HIEs, 4 closed operations and 2 were for-profit operations that were purchased and their HIE operations closed.
* About 55 percent, or 113 HIEs, expect to offer the federally sponsored Direct Project's free, downloadable secure e-mail software for exchanging clinical information;
* Behavioral health and mental health providers are providing and viewing data in 18 HIE initiatives, up from 10 a year ago;
* Forty-six percent, or 117 HIEs, report systems integration is a moderate or major challenge; and
* Laboratory results, medications and radiology reports are the top types of information being exchanged.
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