The federal government may be pouring $548 million of stimulus funding into state-level health information exchanges, but there are a growing number of private HIEs emerging, where an integrated delivery system may link its owned and affiliated providers, or, in some cases, local competitors, to cooperate on data exchange.

It's the private market that many information technology vendors see as their primary HIE focus, says John Moore, managing partner of Chilmark Research, a Cambridge, Mass.-based consultancy.  There typically is a sound business reason for private HIEs: "driving referrals back to the mother ship," he says. That business reason why 21 HIE vendors surveyed by Moore report that nearly 70 percent of their business is in the private market.

Vendors also focus on the private market, particularly delivery systems, because of the "trust" problem among competitors who often find exchanging data problematic, says Brad Hawkins, vice president at Medseek Inc., Birmingham, Ala.

While vendors in the HIE arena see opportunities, many electronic health records vendors remain an obstacle to extensive data exchange among providers.  "A lot of EHR vendors still don't want to play," says Rick Hayes, vice president at InteliChart, Charlotte, N.C. He singles out Chicago-based Allscripts as an exception, saying the company works easily with HIE vendors, even the small ones.

Provisions of the health reform law, particularly bundled payments for an episode of care and establishment of accountable care organizations that will rely on the medical home model of care, will compel EHR vendors to support HIEs, says Phyllis Albritton, executive director at CORHIO, the state-designated HIE in Colorado. "It will be evident which vendors will support doctors with payment reform-- those who don't will fold," she predicts.

Moore, Hawkins, Hayes and Albritton discussed HIE issues during the Institute for Health Technology Transformation's Summer Health IT Summit in Denver.

--Joseph Goedert

 

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