Health Information Exchange: Is it ‘HIE’ Time to Join at Your Practice?

If you’ve adopted an electronic health records system at your practice, you may be considering the next step: joining a health information exchange. Perhaps you’ve even been approached by a local, state or regional HIE or rural health information organization (RHIO) about joining a new or existing network.

You know that data exchange is poised to be one of the greatest benefits of using digital health technology, and is a key tenet of Meaningful Use. But how do you know whether you’re ready to join one? Once you are, how do you know if a particular exchange is right for you?

There are a lot of factors to consider in making the right choice for your business. Ask yourself these questions to determine if it’s ‘HIE time’ at your practice.

How well are you handling data management today?
Joining an HIE is not recommended for those practices that have just finished the move to an EHR system. Even if you’re confident carrying on with your daily tasks on an electronic records system, you’re not ready for an exchange unless you’ve learned how to measure, report and manage your patients’ health data with an EHR. Get comfortable before making any big HIE moves.

Will membership in an HIE increase your efficiency?
An HIE can lessen the effort you spend on retrieving and sending patient health data. Are your staffers frequently handling time-consuming chart transfers? Are your doctors often on the phone with other providers explaining or asking about the basics of patients’ health? If yes to both, participation in an HIE has the potential to save you time.

What’s your patient population’s geographic footprint like?
Consider where your patients live. Do you only see patients from around your town or county? Or do you care for individuals from around the state? Are your older patients ‘snow birds’ who spend their winters elsewhere? Depending on the geographic footprint of your patient base, you’ll need to assess whether a small, community HIE or larger regional org is the right choice for you.

Is this HIE viable, or is it ‘too new’?
While you must eventually join an HIE to meet Meaningful Use, it’s not necessary that you sign up for the first network to emerge and solicit your membership. Most HIE initiatives were launched with funds made available from the HITECH Act of 2009, meaning that the oldest networks are, at most, just over three years old. Unless an HIE has a strong, proven track record, it may make sense to wait it out and join the most mature, sustainable network to approach you.

How will this affect your budget in the long-term?
Since HIE is such a new concept, the payment plans for today’s networks vary widely, and many are still figuring out how they’ll remain sustainable. Would the HIE you have in mind charge you a yearly membership fee, charge you per transaction, or operate on a hybrid model of both? Ask your potential network administrators the tough questions, negotiate competitive rates and figure out how you’ll cover all charges if you decide to sign up.

Will you need to join more than one?
As your practice expands and the number of HIEs available to you grows, you may find that you’ll need to join multiple HIEs to work with hospitals or other provider groups and accommodate the needs of incoming patients – in fact, that may be the case already. Keep this in mind as you select your first HIE so that you don’t become so overextended financially with one network that you can’t jump onto another.

How happy are you with your technology?
When you join your first HIE, you’ll be taking into consideration how well the exchange can integrate with your current EHR and practice management systems. But will you still be using those same systems in two years? Or five? If you’re considering replacing any of your technology systems in coming months, look closely into how an HIE operates with solutions from different vendors and how it’s planning to expand its integration capabilities.

What do you have to sign?
As with any business decision, inspect your contracts with an HIE closely – especially if you have any hesitations about the network’s viability and usefulness for your practice. If you find no benefits to using a particular HIE after being a member for a while, you’ll want to be able to terminate that relationship without incurring negative consequences or entering into legal disputes about data ownership. Make sure an attorney looks over all paperwork.

How did you know it was time to join an HIE at your practice? How did you know a certain network was right for you?