Hospitals and health systems are facing significant challenges in sharing data through regional health information organizations, according to a report recently released by HIMSS Analytics.
The report is based on responses of 158 CIOs and other IT executives at hospitals and health systems, collected between May 2013 and June 2013. Many of the responding organizations currently share data — 73 percent of respondents reported participating in some kind of health information exchange, with the majority (57 percent) participating in a single exchange.
Of those participating in an exchange, 57 percent of respondents reported participating in a state RHIO, 32 percent participate in a local or regional HIE organization, 19 percent participate in an HIE run by an integrated delivery network, 13 percent participate in an HIE run by a vendor, 1 percent participate in a private HIE run by a payer organization and 1 percent participate in a statewide HIE run by a disease-specific organization. Technology used to facilitate data exchange varied among respondents from portal access (44 percent) to DIRECT message exchange (40 percent) to query-based exchange systems (32 percent).
"This is really a growing area of interest for hospitals," says John Hoyt, executive vice president of HIMSS Analytics. "Hospital CIOs had been motivated [by meaningful use incentives, etc.] to get these systems into place — and now the motivation is to interconnect and exchange data."
The organizations that participate in data exchanges do see benefits. More than half (52 percent) of respondents cited benefits associated with better access to patient information, 20 percent said the exchange promoted patient safety and 12 percent said the exchanges led to time savings among clinicians. Sixteen percent reported seeing no benefit.
However, many respondents also reported significant hurdles to data exchange. The top challenges reported by hospitals include other organizations not robustly sharing data (49 percent), limited staff (44 percent) and resources (40 percent) and privacy concerns (39 percent). Hospitals and health systems not currently participating in an HIE cited budget limitations (49 percent), lack of available HIEs in the region (34 percent), staffing constraints (29 percent), limited technology solutions available on the market (24 percent) and other priorities within the organization (15 percent).
"What concerns me is the difficulty hospitals are having with achieving this interoperability and exchange," says Mr. Hoyt. "It's a concern for me, for HIMSS and for the federal government. Small organizations that may have capital or labor issues are being asked to do things that will ultimately be beneficial, but are strenuous."
Mr. Hoyt worries hospitals with the resources to join and fully participate in HIEs may hesitate to do so also out of a desire to preserve market share. "Regional competition often means they're less motivated to share data," he says. "It does happen in highly competitive markets."
However, Mr. Hoyt believes not participating in HIEs will be detrimental to patient care. In the near future, "I'd like to see the social benefit [of HIEs] to override hospitals' competitive instincts. We should just do it for the good of healthcare," he says.
"If you showed up in the emergency department, wouldn't it be great if they already had your allergy list?" As patients, and as citizens, "you and I have the right to expect that to happen," he says.
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