Question

How does HIE's support organizations who are trying to achieve Meaningful Use and receive their incentive dollars?

Answer 1

The federal government has been actively encouraging health information exchange through direct grants and leadership. However, its challenge now is keeping focused and getting the multiple efforts aligned.

Electronic health records (EHRs) is becoming more and more common. It is anticipated that their use will improve patient care, decrease practice costs, and increase provider productivity and revenue.An electronic health record (EHR) is an electronic version of a patient’s paper record. EHRs offer the advantage of making information about patient care available, in a secure way, to multiple authorized users. EHRs have the potential to integrate information from multiple sources and provide a more comprehensive view of patient care although this has proven challenging to achieve in actual practice. EHRs also may provide access to tools like clinical decision support reminders and reports that aid clinicians and teams in delivering care based on the best-available evidence. EHRs make it possible to share and manage information across multiple providers, labs, specialists, imaging facilities and organizations through health information exchange (HIE) platforms so that information is available to and from all clinicians involved in a patient’s care.

The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs.

The Office of the National Coordinator (ONC) for Health IT is attempting to do in a few years what the private sector has not achieved in decades-create a wide network of healthcare providers exchanging patient information through electronic health records (EHRs).

It is a daunting task, but one that ONC has seen significant progress on since the American Recovery and Reinvestment Act of 2009 named EHR adoption and health information exchange (HIE) a priority. ONC and the Department of Health and Human Services have distributed hundreds of millions of dollars through targeted programs intended to foster EHR implementation and the advancement of state-level HIEs.

But in the push to spur EHR adoption, some say ONC's focus on HIE has waned. While ambitious programs like the Regional Extension Center program and the meaningful use EHR incentive program give providers technical and financial support for EHR adoption, similar efforts to develop HIEs have been slower to develop.

Millions of dollars are going to be issued to providers for meeting meaningful use targets, and that money should in part ride on a provider's use of the state-level HIEs, Frohlich says. This could be done by allowing providers to achieve meaningful use requirements by directly reporting information through their state-level HIEs.

"If those meaningful use targets are heavily dependent on HIE activities, then what the market would tell you is there will be more attention to purchasing and implementing HIE solutions, which should be born from the HIE cooperative program," Frohlich says. "If the meaningful use criteria are light on HIE and have minimal requirements, in many respects there is not a lot to drive adoption of the HIE services that are being built by these states."