Cost Still Blocks HIE Adoption, Health Execs Say

5 Key Elements For Clinical Decision Support Systems

While healthcare executive applaud the benefits that health information exchanges (HIEs) can provide--such as improving the quality of clinical reporting and the coordination of care among physicians--the high costs of participating in an HIE is still an impediment, according to a study from healthcare management consulting firm Beacon Partners.

The study, which relied on interviews with more than 200 healthcare C-suite executives, found that 41% of respondents consider high start-up costs and insufficient capital to support HIEs as their top concerns. Additionally, 38% of respondents said they have annual budgets for HIE development of less than $1 million, while 21% have no budget at all.

"These organizations will rely on seed money, start-up funding, or grants (federal designations)," Kevin Burchill, director of Beacon Partners, told InformationWeek Healthcare. "The problem with this model is that there is a varying level of commitment to the HIE program, and for those that are too dependent on the seed money, it affects the long term sustainability of the HIE program. When the seed money goes away, these organizations have to realize that they have to be committed to putting their own skin in the game."

Among the 200 healthcare executives interviewed (more than half of whom are CIOs), most respondents (58%) were from community hospitals, while the other 42% work at critical access hospitals, academic medical centers, multi-specialty group practices, ambulatory clinics, faculty-based practice plans, and single-specialty practices. While these healthcare delivery organizations have limited budgets, the report revealed that a majority of respondents--nearly 70%--are currently planning to participate in an HIE.

[ How do you implement a successful HIE? Read Strategy: Health Information Exchanges That Work. ]

Another key finding of the study is that 64% of respondents named the CIO as the person responsible for HIE development, while governance and planning with potential connecting "partners" are the responsibility of others in the C-suite leadership group. According to Burchill, the inherent problem with this is that the CIO is expected to connect the dots after the other part of the C-suite might have made governance considerations.

"This can create a major disconnect. The CIO should be part of the HIE development process from the get-go, sitting at the table with the CEO, who has the vision; the CFO, who contributes financial input; and the doctors and nurses, who have clinical input," Burchill said. "The responsibility has to match the accountability, and when everyone is working together there will be internal alignment to the success of the HIE."

The study also found that approximately half of respondents have not yet created a department, oversight group, or executive role to handle the HIE initiative.

"This tells me that the healthcare organization is only making a halfhearted commitment to this initiative," Burchill said. "An HIE has to be part of an organization's core values, where a commitment to the necessary internal resources is made, which is important to the future success of this program."

Costs and governance issues aside, most respondents have a favorable view of HIEs and the positive benefits that exchanges can bring to their organization. The study revealed that 66% of respondents see HIEs as a positive move for their organization, and 42% also believe HIEs will improve patient outcomes, with no respondent saying they believe an HIE would have a negative effect on patient outcomes.

Respondents also noted that HIEs would have a positive impact on their organization in the areas of primary care connectivity (88%), continuum-of-care (84%), clinical quality reporting (74%), patient accessibility (67%), interoperable IT systems (66%), and medical staff alignment efforts (59%).

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