HIE: Keep an eye on the third variable
Mary Stevens, editor, CMIO
Health information exchange is reaching critical mass in some areas. For example, when it comes to state HIE initiatives, New York leads the pack with 14; Florida is second with 11, and California and Oklahoma each have nine HIE projects underway, according to the HIMSS State HIT Dashboard. Most states have at least one HIE. And as the “Five HIEs to Watch” feature in the February edition of CMIO showed, the information being exchanged varies tremendously.

Expect a lot of discussion at HIMSS11 about recent HIE milestones, such as the two Direct Project pilot projects (formerly known as the NHIN) that are now are up and running, exchanging information using the Direct framework. But that’s just the beginning, Pamela Matthews, RN, MBA, HIMSS senior director of regional affairs, said in an interview.

Direct and other initiatives will only continue to increase and facilitate the adoption and use of EHR, “and more importantly, the actual exchange of data,” says Matthews. “At the state level, several Direct pilots are working on HIE activity on a large scale. They’re looking at ways to  leverage and incorporate Direct in their activities. It’s going to be very exciting to see how Direct will be leveraged as we continue on this journey.”

One session at the HIMSS HIE Symposium on Sunday will feature three state-level HIE initiatives that are at different points on the journey. This reflects the fact that HIE projects, initiatives and activities are at various stages across the country, says Matthews. “I would look at the HIE Symposium from two perspectives:  the strategic perspective; and the practical perspective—What can I use today in my organization, [and] what can be useful in planning for the future?” she says. “It’s also important to show organizations where their peers are in the process… in order to increase awareness of what’s out there and what others are doing.”

Right now, federal agencies “are really in the driver’s seat, based on HITECH and what has occurred,” she says. Throughout the HIE Symposium, at HIMSS educational sessions and at the  (much expanded) Interoperability Showcase, key agencies including the CDC, CMS, FCC and ONC will be featured. “These are key agencies that HIE stakeholders need to be aware of and really be tuned into their activities around HITECH, implementation of meaningful use, and the implications that HITECH has on HIE.”

Other sessions in the HIE Symposium will “be getting into the brass tacks,” featuring what state level HIEs and others are doing around issues of data exchange and financial sustainability, and what is happening today, says Matthews. For example, an HIE-themed Town Hall meeting at the HIE Symposium will look at HIE from various perspectives as well as what’s in store for next-generation HIEs.

Looking at that next generation of HIEs—say, in 2013—what information is being exchanged via HIE? Matthews looks at them in three ways:
  1. "We know that HIE is going to be pivotal for the success of achieving meaningful use, that’s a given. It’s pretty well outlined and will continue to be clarified with the future requirements of meaningful use future states,” she says.
  2. We know the stipulations included in the HIE state-level cooperative agreements; The focus will be on the states HIEs. They are focused very keenly on being successful as well as complying and meeting requirements of the (state level cooperative) contract.” The state-level cooperative agreements will allow for broader data exchange than just the requirements for meaningful use, Matthews explains.
  3. “The third variable is really variable: We know there are some other emerging areas, like consumer engagement, even beyond what’s stipulated in state level cooperative agreements. That’s where it will be the function of the diversifying HIE, the stakeholders that come to the table, and geographic location that’s defining the markets. That will reflect the creativeness that an HIE organization will deploy with their services. Data exchange may be above and beyond the federal and state requirements.

“That’s what the exciting part of this is—the creativeness of where HIEs can continue to grow and develop in areas that we can’t see right now. I think there will be those organizations that will be able to succeed and then excel. And the excelling is where that additional focus of services will occur.”

With more than two dozen HIE-oriented educational sessions, CMIOs and other show attendees should see plenty of ideas for excelling—and accelerating—HIE, or maybe just getting a fledgling information exchange up and running. If you cannot attend HIMSS11, check out CMIO.net’s daily coverage from the show floor, for insight into CDS and the other hot topics in Orlando.

Mary Stevens
Editor of CMIO