Up at 5AM: The 5AM Solutions Blog

Three good reasons why health information exchange is worth the trouble

Posted on Thu, Feb 24, 2011 @ 01:21 PM

Health information exchange, or HIE, has been in the news a lot this week, with many players in health IT gathering at the annual HIMSS (Health Information Management System Society)conference, where sessions formal and informal covered the numerous benefits and complications related to the exchange of health information.


    1. Because starting simple is still starting. And, it’s pretty simple. Deep in the bowels of a Continuity of Care Document (CCD), we can run into serious interoperability pain. One system uses SNOMED, and another uses a home-grown system and syntax. Another system puts the name of the immunization, rather than the product name, into the Free Text Product Name of the Immunization Module (this is actually happening among our clients). The more we get into actual machine-to-machine exchange, the more we uncover vagueness in the specs, and implementation realities that are at odds. But before we get to the really hard stuff, let’s start simply. A waterfall approach doesn’t work in software development, and it sure won’t work in HIE. The Nationwide Health Information Network, which 5AM works to support, has really sophisticated and bleeding-edge exchanges going on every day. Many of the partners are dealing with the really hard exchange and integration details. But they rightly took their time getting there. The first step was getting information from one organization to the next, in a “good enough” format so that a stylesheet could render it on a clinician’s screen. This is the first step – can a clinician get information, and make sense of it? We can, and will, have to tackle the hard stuff as we progress. But get started - let grey matter do its work, just get the information out to the person who needs it. (See: NHIN Direct, White House’s Aneesh Chopra on building blocks, google et al)

    1. Because meaningful use benefits will “help” fund the cost – and MU is right on target. 5AM has supported the Office of the National Coordinator for Health IT (ONC) for several years, and we witnessed the careful work the government put into shaping the MU regulations and strategy. Despite its critics, meaningful use certainly gets us on the path (see above). Why should anyone oppose e-prescriptions, allergy lists, or providing patients with an electronic medical record (see more)? The cynic in me thinks that everyone from Dell to Pizza Hut is suddenly creating a health IT business unit just so they can dip into/exploit providers for the incentive money that MU will open up. While that may be true, everyone will benefit from the meaningful use of EHR. Full EMRs and solutions loaded with bells and whistles aren’t affordable or practical for many groups (especially individual practices and small hospitals). This is where the nimble players can make a real difference, by providing straightforward solutions that enable meaningful use to let the information – and incentive dollars – flow to the people who need it.

    1. Don’t take my word for it. Please. Check out the various presentations from HIMSS this week, especially Mark Anderson’s compelling presentation on how he set up a Health Information Exchange (HIE) in Texas. He started simple (see #1), and kept track of the benefits, which include:

        • 73% reduction in unnecessary tests;

        • 87% faster delivery of lab results;

        • 80% reduction in paper exchanges between the participating hospitals and doctor’s offices;

        • 78% reduction in medical errors;

        • Immense reduction in ER visits and costs;

      …and the list goes on and on. Truly. Check out his slides here.

Please suggest more reasons. I’ll tick up the number of “good reasons” as you add comments with more. (Since it’s obvious I’m a true believer that information should and can flow, it’s unlikely I’ll write a blog citing the three good reasons why HIE is not worth the trouble, but I welcome your arguments from that perspective too!)


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