6 HIE Vendors: How They Measure Up

In the wake of President Obama's reelection and a favorable Supreme Court ruling, a growing sense of certainty about healthcare reform is helping to drive the health information exchange market, according to a new report from Frost & Sullivan. In addition, the report notes, the stage 2 Meaningful Use requirements and market changes are increasing demand for HIEs.

Entitled "U.S. Health Information Exchange Market: A Comprehensive Guide to Market Dynamics, Technology Vendors and Future Trends," the research and consulting firm's report predicts that healthcare providers "will significantly ratchet up their participation in HIE over the next 18 to 24 months."

In an interview with InformationWeek Healthcare, Nancy Fabozzi, connected health principal analyst for Frost & Sullivan, estimated that the HIE market will grow 30% to 40% or more next year.

Commenting on the role of healthcare reform in that growth, she noted that until recently, many providers were holding off on HIE participation. "They were waiting to see what was going to happen with healthcare reform before they got involved in an HIE. Now that we have more certainty, many projects that were on the back burner because of finance or political uncertainty are going to go forward."

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Meaningful Use Stage 2, which begins in 2014, will require a greater degree of information exchange between providers than did the first stage of the government electronic health record incentive programs, the report notes. Among other things, providers will have to exchange electronic clinical summaries during 10% of transitions of care, such as referrals and hospital discharges. Certified EHRs will have to be capable of generating those summaries and must be able to send and receive clinical messages using the Direct secure messaging protocol.

Meanwhile, the new care delivery and reimbursement models that are emerging, partly as a result of the Affordable Care Act, require a high level of care coordination. As a result, the press release about the report says, "Participants in HIE will continue to gravitate towards organizations and technology vendors capable of providing a wide range of solutions and services, particularly value-added services that enable patient engagement and predictive analytics needed to better manage patient populations and contain risk, especially for emerging accountable care organizations (ACOs). Leveraging advanced HIE functions is essential for coordinating patient care, improving quality and organizational efficiency, and, ultimately, competitive positioning."

The healthcare overhaul will also increase insurance coverage for millions of people, and the influx of new patients into the system will lead to an expansion in the number of care settings, the report notes. That, in turn, will create a need for health information exchanges so that providers will be able to access patients' records wherever they present for care. Moreover, as mobile devices are increasingly used in healthcare, providers will have to integrate new data streams into a fluid and fast-changing data environment. And with more employers shopping around for the best prices on high-ticket procedures, patients will be increasingly sent outside their region for some kinds of care, the report points out.

"Data has to follow the patient," Fabozzi said. "Patients are going to receive healthcare at home, in retail clinics, in doctors' offices, and in different states or countries."

Fabozzi expects private HIEs to continue expanding more rapidly than communitywide HIEs, because that's where the market demand is today. "But I don't think public HIEs are going to disappear or die," she added. "There's concern that all these HIEs will fall off the cliff because federal funding is going to expire. But I think there are going to be some solutions." Some of those solutions, she added, may involve some kind of government support, perhaps coupled with subscription fees paid by providers.

In a recent survey by the eHealth Initiative, leaders of public HIEs expressed growing concern about their competitive position in markets dominated by private HIEs. But Jennifer Covich Bordenick, CEO of eHI, expressed confidence that community exchanges would survive and thrive, because there's a growing need for them. She predicted that the impact of healthcare reform and Meaningful Use will be positive for public HIEs, just as it will be for private exchanges.