4. 3 Primary Noun Buckets
• Enterprise HIE (“Private HIE”)
– Health system HIE
– Provider Organization HIE
– Vendor-based HIE
• Regional HIE (“Community HIE”)
– Predefined region
– Open region
• State HIE
– State is the HIE
– State provides services to regional and private HIEs
4
Very different…
•Objectives
•Governance
•Funding
•Customers
•Landscape
•Outlook
9. HIE Stages of Development
9Source: eHealth Initiative 2012 Survey of HIE
10. eHI 2012 Survey Key Findings
• Data exchange is increasing
– The number of initiatives solicited in 2012 was 322, an
increase from the 255 in 2011.
– 107 respondents completed the survey in 2012 that also
completed the survey in 2011.
– 54 new respondents completed the survey in 2012.
– 88 initiatives are in the advanced stages of development
(Stages 5, 6 or 7 on the eHealth Initiative’s HIE development
scale), an increase of 15 from 2011
10
11. Exchange Methods (Respondents = 161)
• 106 use a Push Model (Push refers to one-directional electronic
messaging, such as DIRECT)
• 114 use a Query Model (Query/retrieve refers to exchange in
which a query is initiated from one participant and retrieves
data from multiple other sources)
• 89 use an End-to-End Integration Model (Interfaces between
systems enable seamless exchange to take place with no user-
initiated effort required)
11
Source: eHealth Initiative 2012 Survey of HIE
12. eHI 2012 Survey Key Findings
• Data exchange is playing a key role in healthcare reform efforts
– More than half (109) of the initiatives reported that they are
currently supporting ACOs and/or PCMHs
– 63 indicated that they plan on doing so in the future
12
13. eHI 2012 Survey Key Findings
• Federal funding is still supporting many organizations
– The single most substantial source of financial support for
advanced initiatives in 2012 was federal funding, as
indicated by 28 of the HIEs surveyed
– 22 of those 28 HIEs were SDEs
13
14. eHI 2012 Survey Key Findings
• Support of Direct is growing
– The Direct is a protocol that aims to enable secure health
information exchange over the Internet for primary care
physicians, specialists and public health agencies
– 112 HIE organizations reported they are currently
supporting DIRECT or plan on supporting DIRECT in the
future
– The most common use cases are transitions of care and/or
the exchange of laboratory results
14
17. Personal Perspective
• Data exchange will increase outside of the “enterprise box”, but
organizations who facilitate that exchange will consolidate
• Amidst all the experimentation, sustainable models are coming
to the forefront while other models struggle
• Certification of HIE organizations is likely
• Increased recognition that HIEs can’t change the way individual
patients are treated, but are instead another enabler for
clinicians
• EMR interoperability will evolve into Business interoperability
• Standards won’t replace need for clinical exchanges any more
than standards replaced need for administrative exchanges
17