Preparation, innovation among keys to sustainable health information exchanges

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There are plenty of hurdles to health information exchanges--from overcoming interoperability challenges to protecting data privacy and security to convincing providers to put aside their fear of competition to grappling with questions about who owns the data.

But these pale in comparison to an issue that HIEs of all shapes and sizes will ultimately face: How to sustain the operation after initial funding runs out.

In FierceHealthIT's most recent eBook, "Key Lessons in Health Information Exchange," we profile two HIEs; one that is working toward the holy grail of sustainability and one that's already eyeing the next phase--profit.

The recently launched Massachusetts Health Information Highway (HIway) started off with government funding, but also began with an eye toward ensuring its financial sustainability and keeping costs affordable for participants.

"A lot of other states, through limited state grant funding, have provided functionality to providers for free, initially. However, they all will need to figure out a way in the long run to make sure their efforts can continue once those funds dry up," Manu Tandon, secretariat chief information officer at the commonwealth's Executive Office of Health and Human Services, tells FierceHealthIT. "We think we've got a model that's sustainable right from the get-go."

Meanwhile, the Indiana Health Information Exchange, the nation's longest running statewide HIE, began as a non-profit, but is moving to a for-profit model that uses data for products and services, including retrospective analysis, clinical decision support and, eventually, predictive modeling.

Attracting paying customers by offering services they value is "at the very core" of everything the Indianapolis-based exchange has done since its founding in 2004, says Keith Kelly, IHIE vice president of professional services.

IHIE has worked hard to find the right mix of services and cost structures. When a fee-per-transaction model flopped, for example, it found success in a subscription model.

There is a common theme among those HIEs that are working toward sustainability and profit: The organizations are not just open to innovation, but actively seeking it out.

"The government is simply creating the foundation," says John Halamka, M.D., chief information officer for Beth Israel Deaconess Medical Center in Boston. "It's up to the private sector to do creative things with that foundation… That's where the real innovation is going to be. Those are the entrepreneurs that are going to use the infrastructure in ways we haven't even thought of yet."  - Gienna (@Gienna)

Learn more about how the Massachusetts and Indiana HIEs are preparing for the future in the FierceHealthIT eBook, "Key Lessons in Health Information Exchange."