Health information exchange progress hard to measure

PHOENIX — What’s the real story about the promise of health information exchange (HIE) build-outs? Still not as clear as one would think.

At the Fall CIO Forum for the College of Healthcare Information Management Executives, experts discussed how many real live HIEs are at work today, and whether they are working or not.

Adam Gale, President of research group KLAS Enterprises LLC, presented data on current health information exchange initiatives as well as his group’s own survey of vendor participation.

Gale first pointed out that KLAS defines an HIE as two non-related or non-owned provider organizations that are sharing data. KLAS does not count point-to-point interfaces within a single organization. KLAS categorizes the two types of HIEs the group looked at as acute-to-acute and acute-to-ambulatory and only counted those that were built on commercial software solutions. (These are to be differentiated from the state-designated HIEs that have received HITECH Act funding, the more than 200 non-government organizations serving as HIEs throughout the country and the federal government’s open source software for health information exchange known as CONNECT.)

Among 26 vendors, KLAS validated 57 acute-to-acute installations, and 65 acute-to-ambulatory. Leading the way among acute to acute were Axolotl Corp.’s Elysium Exchange system, with 10 valid installations, and Epic Systems Inc.’s Care Everywhere with seven. Among acute to ambulatory, Axolotl again was among the leaders with eight valid installations; Medicity Inc.’s Novo Grid and Virtual Information Exchange (from McKesson Corp.’s RelayHealth), led with 17 valid installations, according to the KLAS research.

But Gale indicated that much work is left to do, and confusion over the choices hospital executives will be making in the coming years will bring little clarity to the evolving health information exchange landscape.

For instance, he pointed out that 15 major vendors, including Allscripts Inc., eClinicalWorks LLC, IBM and MEDecision Inc., do not have any validated HIEs, according to the KLAS definitions. In addition, market consolidation has begun, with Ingenix announcing in August it is acquiring Axolotl.

“It’s the Wild West,” Gale said. “Many players will be acquired in the next few years. There will be a lot of shopping going on and buying in this space.”