Interoperability Barriers Plague HIEs
By Christine Kern, contributing writer
A recent survey reveals there a many remaining challenges.
The results of eHealth Initiative’s 2014 health data exchange survey are out, revealing that although HIEs are developing at a quick pace they are still plagued by cost and technical challenges to interoperability.
The annual survey, the 11th in the series, tracks the growth and progress of electronic health data exchange efforts across the United States. Of 267 identified HIEs, 125 respondents completed the survey, including 74 community-based HIOs, 25 statewide efforts, and 26 healthcare delivery organizations.
Among the survey’s key findings was the fact that cost and technical challenges remain central barriers to interoperability, while regulatory policies appear to have encouraged increased use of core HIE services like Direct, care summary exchange, and transitions of care.
The respondents additionally noted advanced initiatives are supporting new payment and advanced care delivery models, while sustainable organizations have replaced federal funding with revenue drawn from fees and/or membership dues.
“Overall, the data this year was pretty similar to what we’ve seen in the past couple of years,” said Alex Kontur, research analyst at eHealth Initiative, during a Web presentation of results, according to Health Data Management. “On the technology side, we’re still seeing a lot of activity around interface development. Pretty much every organization that we surveyed has had to construct multiple interfaces with different EHR systems.”
Among the challenges to interoperability cited by survey respondents were: financial costs of building interfaces (74), getting consistent and timely response from EHR vendor interface developers (64), and the technical difficulty of building interfaces (48).
Compared to the 2013 results, this year’s survey demonstrated many of the same challenges. Respondents “continue to struggle with interface development as they work to stitch together disparate systems,” the Webinar revealed. Of those surveyed, 112 organizations have had to construct multiple interfaces, with 18 building more than 25 interfaces.
“Cost was the most frequently cited challenge to interoperability,” said Kontur according to Health Data Management. “Part of that has to do with the fact that the organizations owning the EHR or the HIE itself have had to bear the brunt of costs for interface development.”
Three-quarters of respondents (101) incorporate secure messaging into their data exchange models, 81 respondents access data through secure messaging, and 78 respondents offer a Direct address directory. The results also indicated that 85 respondents have implemented notification/alerting services to support transitions of care, representing a 27 percent increase over 2013, while 108 respondents (a 23 percent increase) offered care summary exchange as a service, and 74 respondents offer reporting to immunization registries (an 18 percent increase).
Of the respondents, 106 reported that their organization had reached stage 5 or higher on the eHI’s HIE maturity scale, marking an 11 percent increase over 2013. Of those, 64 support an ACO, 52 support a patient-centered medical home, 21 support a State Innovation Model (SIM), and 12 support a bundled payment initiative, according to the webinar materials.
Ultimately, the study reveals, the future of HIEs will require innovation and collaboration to ensure success and interoperability across the board.