The changing market climate has improved incentives for the adoption of healthcare information technology and health information exchange and as a result HIT and HIE are “beginning to take off,” according to Micky Tripathi, president and chief executive officer of the Massachusetts eHealth Collaborative.

“Up until five years ago, the healthcare system had notably underinvested in electronic health records and health information exchange compared both to other sectors in the economy and other industrialized countries,” said Tripathi. “But, we’ve made a tremendous amount of progress based on the Meaningful Use program over the last few years.”

Tripathi, who gave the industry perspective March 20 at a Federal Trade Commission workshop in Washington, argued that Meaningful Use Stage 1 has been “an enormous success” and “now what we are seeing is a lot of tension in what’s the appropriate role of government” in Stage 2 and Stage 3.

At the same time, healthcare technology is a diverse and highly dynamic sector that is rapidly changing to the point that technology is “moving just as fast, if not faster, than the business models,” said Tripathi, who also serves as chair of the information exchange workgroup, a subcommittee of the Health IT Policy Committee that advises federal officials.

He defined HIT as electronic health records or other clinician-based applications that help with treatment, such as decision support, diagnostics, documentation, and order entry, while HIE “refers to the technologies that allow those distinct instances to talk to each other.”

Tripathi asserted that health information exchange is maturing from what he called HIE 1.0 to HIE 2.0 and is emerging as a multi-layered set of “somewhat discrete” functions.

“Health information exchange is a verb and it’s multi-layered and demand-driven with lots of people wanting to do this from the bottom up, which is a good thing,” he said. “It’s much more tactically focused led by a wide variety of organizations, some of them state-level kinds of organizations but more and more the private HIE phenomenon which is accountable care organizations and others who are doing it to serve that immediate business need.”

The current HIE 2.0 phase includes a layering of direct messaging that was started with Meaningful Use Stage 2 and it is also provider-centric, said Tripathi.

“Query and retrieve is now starting to grow as a market phenomenon, not yet a part of Meaningful Use requirements,” he said. “So, there’s a little bit now where the market is getting out ahead of where Meaningful Use is. We’ll see where that goes but it’s certainly growing and developing.”

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