Cost and technical challenges remain central barriers to interoperability for health information exchanges (HIEs), according to the recent eHealth Initiative survey. The research also showed that regulatory policies have seemingly encouraged increased use of core HIE services, such as Direct, care summary exchange and transitions of care.
The 11th annual survey on health data exchange used information from 125 identified HIEs, including 74 community-based HIOs, 25 statewide efforts and 26 healthcare delivery organizations.
The financial costs of building interfaces was cited by 74 respondents as a main interoperability challenge. Moreover, getting consistent and timely response from EHR vendor interface developers and the technical difficulty of building interfaces were cited as issues by 68 respondents and 48 respondents, respectively.
“The 2014 survey findings demonstrate a steady increase in core data exchange services, particularly around priority areas supported by financial incentives or regulatory policy,” the report stated. “Direct continues to expand as an exchange mechanism for providers and organizations and makes up a large and growing portion of data exchange activity.”
For example, the number of respondents using Direct for transition of care services in 2014 increased by 22 percentage points from 2013. The exchange around priority areas of Stage 2 of the Meaningful Use Program also increased in 2014. Specifically, 108 respondents (81 percent) offered care summary exchange as a service in 2014, which is a 23 percent increase in utilization since 2013. Additionally, 55 percent of those surveyed offer reporting to immunization registries in 2014, an increase of 18 percent.
As the healthcare industry continues to evolve, the study’s authors explained that organizations should continue to work collaboratively to overcome remaining obstacles.
“The rapid growth of both DirectTrust and eHealth Exchange is a promising step toward defining a floor for data exchange capabilities nationwide. Other collaborative efforts, such as the Mid-states Consortium and National Association for Trusted Exchange (NATE) are tackling the many different policies impacting exchange across state lines,” the report said.
The eHI research also showed that three-quarters of respondents incorporate secure messaging into their data exchange models, while 61 percent organizations have users access data through secure messaging. Lastly, 58 percent of respondents offer a Direct address directory.
Another key finding in the survey was that advanced initiatives are supporting new payment and advanced care delivery models. Of those surveyed, 106 reported that their organization had reached stage 5 or higher on eHI’s HIE maturity scale, which is an 11 percent increase over 2013. Of those, 51 percent support an ACO, 41 percent support a patient-centered medical home, 17 percent support a State Innovation Model (SIM), and 9 percent support a bundled payment initiative.
Previously, Jennifer Covich Bordenick, CEO of the eHealth Initiative, spoke with HealthITSecurity.com about the future of healthcare. Bordenick somewhat echoed the results of the eHI survey, and explained that best practices still need to be decided upon by the industry and better communication will go a long way. Essentially, it can be difficult to find a balance, and organizations will need to “tread carefully over the next few years,” she said, adding that the road might be a bit bumpy.
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