For healthcare providers, adopting a health information exchange (HIE) requires more than simply changing paper-based workflows to the electronic equivalent. Farzad Mostashari, MD, National Coordinator for Health Information Technology, confirmed this reality in a recent interview by the American Association of Family Physicians.

Mostashari stated that simply shifting paper-based processes to a digital system would only cause existing challenges to resurface in a different format. In order to realise the full potential of HIE and motivate providers to invest in these services, healthcare leaders must establish a system that revamps traditional care processes, enables ongoing provider and patient interactions and equips clinicians to provide the best care possible.

My experience leading the implementation of Inland Empire Healthcare Information Exchange (IEHIE) has confirmed that developing a health information exchange that allows organisations to thrive in a quickly changing industry is possible. Since launching IEHIE in 2012, the system has connected 48 organisations to five million patient records in the Riverside, San Bernardino and San Joaquin Counties of Southern California. With tools that enable seamless communication between providers and comprehensive analytics for assessing population health trends, providers continue to benefit from their investment in the technology, making IEHIE one of the only self-sustaining HIEs in the country(a key challenge facing many state HIE organizations that are supported primarily by federal funding).

What has made success in Inland Empire possible? To start, the HIE infrastructure must be backed by a plan that incorporates all stakeholder needs. IEHIE began its development phase three years before launch, with collaboration between Riverside County Medical Association, San Bernardino County Medical Society and the Hospital Association of Southern California. From the beginning, we encouraged all stakeholders to share their opinions and concerns regarding a region-wide exchange. Now participants regularly bring feedback on standards, governance and implementation process to the table, knowing that their voice is heard. This motivates the group to extend their enthusiasm to the wider care community as IEHIE plans for the future. Our organisation has been able to knock down the walls blocking a successful exchange by establishing community-wide trust.

Although patient populations differ across the nation, the services that contribute to a successful health information exchange are similar across regions. Clinicians need a technology that offers access to the following assets:

1. Historical Patient Record

The fact that patients visit different providers along their treatment journey will never change. Saving patients from the time and energy required to transport their medical information from provider to provider is a key benefit of HIE. Quick access to a patient's full medical history—without reliance on a fax machine—is crucial for providers to make the most any patient encounter. Building an exchange that supports a standardised, longitudinal patient record that providers can pull electronically will greatly inform treatment decisions and allow the care team to take all patient interests into account.

2. Data Integration and Interoperability

In order for the HIE to reach full value, it have the ability to exchange patient data between systems without losing the meaning and value of the pieces of information exchanged. Organisations must ensure that patients' healthcare data is never compromised during transactions. By offering a central integration point that data can flow in and out of, providers can effectively collaborate and share relevant patient information with the entire care team.

3. Care Team Communication

As the industry moves toward collaborative care and payment models, providers need the ability to easily send and receive messages regarding sensitive patient information. Direct messaging, a communication system similar to email, will help providers stay updated on patient progress and work together to establish a solution. The HIE provides the infrastructure to make this communication possible and gives providers the ability to stay connected.

4. Patient Population Insight

The trending lines within the clinician's wider patient community are crucial for establishing clinical pathways to address common issues. Through business intelligence tools, providers can easily analyse vast amounts of data on a specific patient population, pinpoint warning signs and develop strategies for redirecting unhealthy behavior.

By continually providing new services aimed at improving patient care, our organisation has remained a relevant and valuable partner to area hospitals, medical groups, associations and clinics.

As industry experts follow HIE trends, IEHIE has been cited as a 'hybrid HIE,' leveraging attributes of both public and private models. From the beginning, our organisation knew that in order to be sustainable, IEHIE needed to incorporate qualities of both sectors. To do this, IEHIE follows the approach of a private HIE and is supported by a self-sustaining fee-based model and a 501c3. The development started locally and is gradually expanding to new regions. Simultaneously, the mission of IEHIE remains rooted in the core goals of public state HIEs, which aim to develop an infrastructure that supports the state and nationwide exchange of patient healthcare information. By focusing on the unique needs of our participants, expanding our reach overtime, and continually adding services that make way for healthcare innovation, we believe IEHIE will serve as the blueprint for State Level HIE's across the nation and ultimately improve the patient experience.

What is your organisation's blueprint for HIE success?