The idea behind a network is that it grows stronger as more participants join it. A basic example is a cell phone provider that allows its members to make free calls to other members – the policy becomes more valuable as more people join the network.
Health Information Exchanges (HIEs) work on the same principle – networks connecting electronic health record (EHR) systems, pharmacies, Medicaid Management Information Systems, etc. The idea is sound, but the information shared is only as valuable as the number of participants and the quality of the data and resources.
Interconnectivity and interaction among providers can potentially do so much to raise the standard of patient care that it’s important we do all we can to facilitate participation in HIEs. With that said, we must recognize that it takes time to build quality and we want to make sure we’re getting it right.
In Neil Versel’s article earlier this week he notes that the College of Healthcare Information Management Executive (CHIME) formally asked for more time to transition from meaningful use Stage 1 requirements to Stage 2 because it’s unclear if many physicians and hospitals are even ready for the first stage. CHIME recommends that 30 percent of eligible hospitals and providers have been able to demonstrate EHR meaningful use under Stage 1 before moving to Stage 2.
This is an important consideration in the HIE network conversation. EHRs are a critical component of HIEs, and in order to build a meaningful number of participants in HIE networks, I’m glad to see discussion around making sure providers have the appropriate amount of time to grow comfortable with new technologies and workflows.
The Wyoming Department of Health (WHD) is an example of an organization working diligently to develop an effective HIE network. Affiliated Computer Services, A Xerox Company, is helping WDH to implement a Web-based EHR and HIE system that will integrate with the state’s MMIS, other EHR systems, designated laboratories and the state’s immunization registry – working toward the goal of using healthcare IT to its fullest potential to manage patient care.
I hope the conversations that begin this week at HIMSS continue on this important topic.
This article brought to you by Xerox Corporation: http://bit.ly/f7vdh8.
Jack Buxbaum is vice president, Health Information Exchange Services, Government Healthcare at Xerox.
Nice to see your keepin busy
Network effects don’t kick in until the network reaches critical mass.
Most HIEs (the noun) still have a long way to go:
1) No critical mass of data. Most HIEs currently exchange only subsets of health information, e.g., lab tests, report summaries
2) No critical mass of participants (lack of direct network effects). Not all doctors, hospitals and other care providers have joined the HIE. This is particularly problematic where a hospital leads a private HIE.
3) No critical mass of applications (indirect network effects). HIEs should be thinking of themselves as platforms that provide applications, ala iPhone + 300,000 apps. The lack of consumer connectivity and apps is a big hole.