Participants in the State HIE Program believe its existence has increased awareness of HIE and that the value of the program will grow as it solidifies ties with supporting programs, such as accountable care organizations (ACOs).
The ONC created the State HIE Program in 2009, when it offered $564 million to states willing to develop the electronic exchange of health information. More recently, the ONC tasked NORC at the University of Chicago with measuring the progress of the program.
NORC conducted case studies in six states — Iowa, Mississippi, New Hampshire, Utah, Vermont and Wyoming — and its researchers interviewed 108 individuals with different roles in the HIE process, including health IT staff, state public health officials, Medicaid personnel and vendors. NORC’s researchers uncovered that exchanges of care summary documents, lab results and public health reporting are among the most common services rendered by HIEs. Participants in the HIE program agreed that defining incremental goals and sharing progress with project stakeholders are reliable ways of building and maintaining support for a project as complex as joining a statewide HIE.
Representatives from multiple states said HIE is critical to ACOs because ACO members need to share patient information across facilities. Iowa has directly linked HIE to ACOs by requiring healthcare organizations that are starting an ACO to also sign up for the statewide HIE, the Iowa Health Information Network. In other states, instead of building an entirely new infrastructure to share data with other providers, “newly formed ACOs can turn to existing HIE infrastructure for a fee.”
Representatives from all six states studied by NORC reported IT hiccups during their HIE implementation. Their issues included poor system interoperability and problems with EHR and HIE developers that caused them to mix and match vendors to fit their needs.