Twenty-six percent of U.S. hospitals do not belong to any kind of health information exchange organization, according to a recent report from HIMSS Analytics. Many of those not currently participating cited budget concerns, privacy concerns or competing priorities within the organization.
Great Lakes Health Information Exchange, an HIO based in East Lansing, Mich., started out as a local community collaborative and has since expanded to all of Michigan. GLHIE has 14 hospitals live on the exchange and is negotiating contracts with several more.
Carol Parker, executive director of GLHIE, says most hospitals are willing to share why they haven't joined yet, and many express the same hesitations. Below, she shares (and corrects) three common misconceptions about HIOs.
1. HIOs are expensive. Many of GLHIE's potential clients have recently implemented an electronic medical record system, a costly undertaking, and are hesitant about making additional investments. "A lot of the time, people assume an HIO is going to be as expensive as an electronic medical record system — that could really give them pause," says Ms. Parker. However, the cost of participating in an HIO is often negligible compared to the cost of an EMR, she says.
To help organizations better understand the costs of joining a HIO, Ms. Parker and representatives from GLHIE have been meeting hospitals' CFOs as well as the CIOs. "It's helpful to have them get a sense of the real cost and better understand the return on investment," she says. While the pricing varies between hospitals based on size, the number of providers and the desired HIO functionalities, Ms. Parker estimates a 300-bed hospital would pay less than $50,000 per year. "It's really very reasonable," she says.
2. HIOs are less secure than current systems such as faxing. Many healthcare providers worry HIOs do not take the necessary steps to ensure data security and HIPAA compliance. Even among hospitals that are sharing data over an HIO, 39 percent have concerns about protecting medical privacy, according to the HIMSS Analytics report.
"One of the main challenges we have is explaining all the tight monitoring procedures we have in place," when speaking with potential GLHIE members, says Ms. Parker. Like many other HIOs, GLHIE has an extensive data exchange agreement to protect patient data, a chief privacy and security officer who audits and monitors the data exchange to ensure it meets all governmental and industry standards and is recommended for full accreditation by the Electronic Healthcare Network Accreditation Commission.
3. HIOs are not a current priority. Many providers in GLHIE's region are suffering from "IT fatigue," says Ms. Parker. "They've already had to go through a lot of changes to meet meaningful use," she says. "For many of them, this is just one more thing."
For Ms. Parker, HIOs are one more important thing. "Having the right information at the right time is critically important to providing the best patient care and managing risk," she says. As hospitals begin to adapt to embrace population health management and performance-based reimbursement policies, having access to the kind of data provided by an HIO will become more important, particularly when its delivered within the provider’s workflow. "It will be challenging to make that work without having information on care delivered to the patient outside of the health system’s network," says Ms. Parker.
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