When the HITECH Act went into effect, the state of Illinois was largely unprepared for health information exchange (HIE). Three years later, the state has several HIE entities -- one of which, the Central Illinois HIE, has essentially built itself from the ground up and now counts among its members 20 health departments, nearly 3,000 physicians and 27 hospitals, representing half of the region's bed count.
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At the recent Institute for Health Technology Transformation's iHT2 Health IT Summit, Central Illinois HIE Interim Executive Director Joy Duling explained how emphasizing the benefits of HIE to physicians, providers and especially patients has helped CIHIE grow.
Meaningful use and other federal incentives aimed at encouraging health IT adoption make this a great time to get health information exchange done, Duling said. That said, the process should be regarded as a "dimmer switch" that starts low and turns up as it goes. For CIHIE, the goal is 80% participation among hospitals, providers and local agencies within five years, with the understanding that 100% participation won't happen, she said.
Six ways to sell the benefits of HIE
CIHIE has used six specific strategies to help demonstrate the benefits of HIE to its constituents in 20 counties.
- Remember that everyone has a story. In Duling's case, it was receiving treatment for thyroid cancer at three hospitals and many other facilities in the region and learning the hard way that no one had access to all her personal health information (PHI).
- Create an army of evangelists who tout the benefits of HIE and aren't afraid to talk to their doctors about it. (CIHIE offers a one-page download that helps patients bring up the subject.) When this happens, Duling said, patients will come to accept health information exchange as a common business practice in Central Illinois -- and beyond.
- Eschew jargon and speak the language of trust so patients and providers know exactly what HIE means.
- Be where the people are. The technology is important -- CIHIE uses a federated data model based on Health Level 7 International Inc. (HL7) standards -- but the organization doesn't sell itself that way. Rather, the message, spread through spots on consumer-oriented radio and TV programs, emphasizes the consumer benefits of HIE.
Create an army of evangelists who tout the benefits of HIE and aren't afraid to talk to their doctors about it.
- When it comes to HIE implementation, be flexible. Don’t force every organization to use the technology in exactly the same way. Doing so may obscure the overall benefits of HIE and fail to convince reluctant organizations to sign up.
- Above all, raise expectations and be the future. When this happens, Duling said, outsiders stop asking whether they should join the HIE and start asking when they should join.
More secrets to successfully reaping the benefits of HIE
Since so much care occurs outside acute care and ambulatory clinics, HIE organizations must look beyond large hospitals when drumming up support, Duling said. This increases the odds that patients will reap the benefits of HIE, but it comes at a price, literally, since smaller facilities lack the deep pockets that larger ones have. To make sure that critical access hospitals and federally qualified health centers can participate, HIE organizations must stay affordable, she said.
Giving patients access is also an "inevitable" must, Duling said, adding that CIHIE will be rolling out a patient portal soon.
Finally, it pays to adapt the think globally, act locally mantra to HIE. Part of the reason Illinois has been able to make up for lost time, Duling said, was splitting the state into 16 different medical training areas, each with a local focus. This brought many more stakeholders into the conversation than if the effort had been led in the capital (Springfield) or the largest city (Chicago).