8 Health Information Exchanges Lead The Way

IDC Health Insights has identified several top vendors offering technology tools and strategies for health information exchanges (HIEs) building statewide exchanges. Their evaluations, outlined in two recently released reports, highlight the shifting landscape of an evolving HIE market, according to Lynne Dunbrack, IDC Health Insights' program director for connected health IT strategies.

Dunbrack, the author of both reports, noted that two years ago HIE executives were focused on connecting the ecosystem and making plans to transmit data between health organizations to qualify for Meaningful Use incentives. Today the focus has shifted to harnessing the data into "actionable information" that supports accountable care organizations (ACOs) and coordinated care initiatives.

The HIE market has also matured, moving from regional government grant-funded HIEs to a more self-sustaining enterprise market, where private exchanges seek to create a business model that generates revenue from HIE stakeholders. IDC's research indicates that nearly all 50 states have identified a vendor partner (or partners) for their statewide HIE initiative. IDC's reports also confirm recently published research that private HIEs are the fastest-growing market segment.

Monday, the IT research firm released IDC MarketScape: U.S. Health Information Exchange Platform Solutions 2012 Vendor Assessment. The report provides an evaluation of 16 software platform vendors described as having software development kits (SDKs), published APIs, technical staff education, a broad ecosystem of partners, and professional services to support the needs of the ecosystem.

This follows last week's release of IDC MarketScape: U.S. Health Information Exchange Package Solutions 2012 Vendor Assessment , in which IDC evaluated 10 vendors that provide packaged systems for HIEs.

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The report noted that packaged systems consist of preconfigured, modular software bundled with well-defined implementation, training, and support services and can be extended to additional users through Web services and APIs. However, when compared with platform HIE tools, packaged systems lack software development kits, are limited in the extension of their technology to a wide variety of software developers, and have approximately a six-month implementation time, versus platform systems that can take between six months to a year.

IDC judged vendors in both categories on the basis of their current capabilities and future strategies, which encompassed many aspects of their business, including: how well their technology integrates with other systems; whether their technology offers mobile connectivity; how well do they collect, store, and sort data; and whether they provide adequate data analytics. IDC also assessed vendors' go-to-market strategies, including an examination of their partnerships and how they advance the technology and expand the customer base; what product pricing and subscriptions fees are offered; whether they leverage value added resellers; and whether their market share is growing.

According to Dunbrack, the ability of packaged or platform technologies to provide business intelligence tools is one of the most important features that HIEs can offer as they look to support physician performance metrics and care coordination among caregivers.

"Some vendors' solutions are more robust when it comes to aggregating and normalizing data to make health information semantically interoperable, for example, but what really moved companies into a better competitive position was those vendors who could offer analytics capabilities, either directly or through very strong partnerships, and who were able to provide patient engagement and care management capabilities," Dunbrack said in an interview with InformationWeek Healthcare. Of those companies offering packaged HIE systems, Carefx and Medicity rose to the top in their group, followed by Certify Data Systems, eClinicalWorks, ICA, Medecision, Caradigm, MobileMD, Infor, and PatientKeeper.

The five leading vendors offering HIE platform systems are InterSystems, Oracle, AxSys Technology, Orion Health, and Medicity. These vendors were followed by Optuminsight, RelayHealth, Carefx, AT&T, IBM, Certify Data Systems, Caradigm, Verizon, Covisint, and Infor.

Regardless of the technology vendors offer, however, the reports say the companies face many implementation and operational challenges, such as:

-- Managing a complex set of technologies involved in the design of an HIE that includes a presentation layer, patient/provider identification, data aggregation, data integration and exchange, information management, identity access management, and development framework and extensions.

-- Constrained IT budgets that force health organizations and HIE vendors to increasingly offer their systems on a hosted and/or software-as-a-service (SaaS) basis, leveraging cloud economics.

-- Privacy and security risks that worry providers as more patient information is transferred from paper charts to electronic health records and made accessible both inside and outside the organization via HIEs and mobile devices.

-- HIE sustainability. Many HIEs weren't able to survive after their grant money ran out. According to both reports, establishing the right revenue model calls for a careful evaluation of how stakeholders will derive value from participating in the exchange. This will depend on what data they want to consume, what they're willing to contribute, and how much they're willing to pay for the service.