KLAS Takes a Hard Look at the Reality of HIE Adoption

Feb. 9, 2010

OREM, Utah – Feb. 9, 2010 – Though marketing by some vendors would suggest that many examples of successful health information exchanges (HIEs) have been built on their solutions, the reality of HIE adoption is quite different. According to a new report from KLAS, only a relatively small number of vendors have risen to the challenge enough times to claim a proven, repeatable model.

For the new report Health Information Exchanges: The Reality of HIE Adoption, KLAS validated 89 live HIE organizations that use commercial technologies to share patient data that is being viewed by doctors. In addition, all of the HIEs included in the study had to be exchanging data among facilities that are not owned by the same organization.

Software vendor Axolotl has the most live HIE clients in the acute-to-acute space, where two or more hospitals or health systems are sharing patient data. KLAS validated seven live acute-to-acute HIE organizations using Axolotl technology. Providers cited the company’s flexible technology and the expertise of its staff with the HIE process as key reasons for selecting Axolotl. Epic also had seven validated acute-to-acute sites. However, Epic is a unique case in that its Care Everywhere solution currently only connects Epic software customers.

Among acute-to-ambulatory HIEs, where at least one hospital or health system is sharing data with a clinic, lab or other ambulatory facility, Medicity’s Novo Grid was the clear leader with 22 live sites. According to providers, the Novo Grid solution is simple but effective, typically funneling lab results from hospital labs and reference labs to ambulatory sites. RelayHealth also had a relatively strong showing in the acute-to-ambulatory space, with eight validated live HIE organizations using its technology.

In total, the KLAS report highlights the commercial HIE solutions of 22 vendors, most of which have one, two or three validated sites.

“It’s no great surprise that, so far, the most successful HIEs are those with the least complex approaches,” said Jason Hess, KLAS general manager of clinical research and author of the HIE report. “The eclectic way that clinical information is structured, stored, labeled and shipped makes it very difficult for vendors to connect all of the discreet data elements. In the majority of cases, HIE vendors are opting to pass around packets of information without necessarily taking ownership of what is in the packet. 

“However, that approach does create some manual intervention with almost every transaction, whether clicking on an icon to see the data, going into a portal to look at it, or opening a separate folder on a PC, especially for a physician without an EMR,” Hess said.

Beyond just the technology, providers also reported a number of administrative challenges they encountered deploying an HIE. Topping that list of challenges were IT governance concerns regarding privacy, security and patient consent, as well as the financial viability and sustainability of the HIE. In fact, when it comes to financing an HIE, KLAS found that among its 89 validated sites, more than 70 percent are funded with state or federal grants.


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