February 29, 2012 2 Comments
A common and unfortunate trend in the Health IT community is a discursive lowering of public HIE’s to a sort of second class status. The thinking is that government funded HIE’s are not sustainable, and therefore not important because they probably won’t be around to exchange your grandkids’ data. Enterprise HIE’s are sexy, evoking visions of big name delivery systems and big name vendors throwing piles of money into the air as they eat caviar and discuss monetization of analytics or value-add services like e-prescribing and EMR-lite. Public HIE’s, on the other hand, are working to implement the most basic of functionality. And of course, whenever project Direct comes up, any organization who admits to putting faith in it becomes a laughingstock. “It’s nothing more than a fax machine.”
Well like it or not, some folks out there still can’t fax. I had the chance to sit in on a call today that changed my mind about the usefulness of the hundreds of Public HIEs struggling to get up and running across the country. I sat in on a public call by the Texas Health Services Authority, who serves as a local coordinator of HIE services and is based out of my new hometown, Austin. The call was to discuss the state of provider and consumer engagement initiatives as they relate to promoting information exchange across the state. In case you didn’t know, Texas is kind of big, so you can imagine the scope of these efforts.
5 New HIEs are being implemented after successfully undergoing the review process of their strategic business/operations plans. There is a massive “white space” initiative that aims to bring some level of connectivity (currently clinical care summaries and lab results as they’re defined in the Meaningful Use program) into the areas of the state where there is none. 5 Health Information Services Providers (HISPS…but let’s just call them vendors) have been approved for that effort, and they receive a $400/$5000 voucher for every provider/hospital they help plug in. In terms of consumer engagement, they’re redesigning the website to help local patients understand exactly what HIE is all about.
The CEO of the Healthcare Access San Antonio (HASA) was also on the call to share their progress there. I found it interesting that the biggest challenges they face aren’t coming up with sustainability models, or facilitating advanced clinical analytics capabilities as an incentive ‘value-add’ for hospitals to join. Rather, it’s simply getting doctors to pick up the phone. How are these organizations spending money? On brochures and website redesign to convince local pharmacies and doctors offices that they ought to be sending their basic scripts and meds data electronically to a website.
Brochures and Websites? To all the public HIE detractors out there, I’ll admit that this work is not sexy. It’s not revolutionary. But it’s very important. While the enterprise HIE’s of the world are training for marathons, the rest of the country is just trying to get moving. As a Health IT community, we should be encouraging these efforts rather than ignoring them. Have you visited your local REC website or looked into which organizations are working on basic adoption? Give it a spin. I’m looking forward to working with the THSA folks over the coming months to do what I can to help them engage consumers and providers. One thing HASA’s CEO said stuck with me: In talking about the importance of a good website, he said, “If we’re promoting technology in healthcare, then we need to be using it to communicate.” Given that I found out about THSA on Twitter, it seems like they’re on the right track.