Ten years ago, Health Information Exchanges (HIEs) were focused on developing a sustainable business model.  Today, their work is driven by a desire to support value-based care initiatives and interoperability.  The participation of Payers in HIEs has grown and helped lead to increased integration of claims and clinical data, says Jennifer Covich Bordenick, CEO of eHealth Initiative Foundation following the release of their annual survey on the status of HIEs.

Supported by Orion Health and represented by more than 50 Health Information Exchange organizations, the 2019 Survey on HIE Technology Priorities uncovered a number of key trends and changing priorities in the sector.  Some of these included the strategic importance of value-based care to decision-making, the increasing demand for maximum data including integration of clinical and claims, and the growing participation of payers.

The initial impetus for the involvement of payers in HIEs came from the providers’ need for more data if they were going to participate properly in value-based care payment models.  By providing high-quality data to the HIEs, payers are able to partially address that need and smooth the path for their provider partners to full population health management.  The increasing need for more data of disparate types presented to clinicians and administrators involved in value-based payment services is clearly driving HIEs’ technology priorities.

Highlights of the Key Findings of the HIE Survey
  • 92% of respondents state that value-based care trends influence their decisions about technology adoption
  • Managing risk and delivery on value-based contracts is one of the top business drivers for 58% of respondents, while easier integration through APIs and providing clear value to end users each represent top drivers for 47% of respondents
  • Respondents are prioritizing interoperability (47%), value-based care (43%), and integrating EMR and HIE workflows (40%) in the next two years
  • Respondents frequently offer services such as provider alerts (77%) and HIE to HIE exchange (72%)
  • Very few respondents are offering services such as remote patient monitoring (6%) and 40% are not likely, or not very likely, to adopt remote patient monitoring in the next two years
  • 67% of respondents have seen a significant or very significant, increase in demand from payers for more access to clinical data
  • The most significant challenges in managing claims and clinical data are data quality issues (58%), cost of technology (56%), and availability of qualified staff (49%)

The above findings were shared during a webinar with industry experts, Joe O’Hara, Director of Clinical Innovation for Horizon Blue Cross Blue Shield of New Jersey, Katie Sendze, Director of Client Operations for HealthInfoNet in Maine, and Michael Sims, CFO for the Delaware Health Information Network.  Moderated by Dr. Chris Hobson, Chief Medical Officer of Orion Health, they discussed the Technology Priorities Survey results in order to better understand the topic in depth.  Much of the discussion and audience questioning was devoted to the need for better access to a broader range and depth of data, crucial to HIEs’ ability to pursue better quality and outcomes while controlling costs.  Privacy and security remain ongoing challenges to the ethical and legally sound use of any health data. Pushing beyond claims and clinical, similar challenges apply when accessing social determinants of health and behavioral health data.  The goal for any type of data use is to understand and leverage that data in the best way possible to gain insights that improve patient outcomes while containing costs.  At the same time, HIEs need to have strong data governance models and information sharing agreements before embarking on the journey.

All webinar experts agreed that the value is derived on a careful, one use-case at a time process to population health management is already delivering more accurate and precise treatments, creating interventions in targeted patient cohorts and having a massive impact on health outcomes.

The participants echoed the importance of the survey’s findings, in particular, the ability to integrate multiple types of data into HIE platforms in order to make HIEs the right place for providers to properly manage clinical outcomes and risks.