Where the Rubber Meets the Road: In Colorado, It’s Around Statewide Interoperability

June 18, 2019
CORHIO Morgan Honea knows the critical success factors for long-term, sustained HIE success—and he'll be sharing his secrets of success next month at our upcoming Healthcare Innovation Summit in Denver

As I survey the nationwide health information exchange (HIE) landscape, a number of key points stand out across the nationwide development landscape. In the past five years, as federal and state funding for the initial development of HIEs has ended, numerous HIEs have gone out of business. In most cases, those HIEs that have ceased operation faced insurmountable challenges on two fronts: the financial/operational and the governance.

On the financial/operational side of things, many HIEs began with grant money, a hope and a prayer. And that in itself is not a bad thing; ten years ago, it was difficult to foresee exactly where the HIE journey was taking everyone, and we had just seen Congress pass the HITECH Act as part of the ARRA (American Recovery and Reinvestment Act), which President Obama had signed in February 2009.

So, to be clear, ten years ago, the path forward was shrouded in considerable mist. What was known was that the need—which had existed from time immemorial—for clinicians and providers to connect to one another with key patient and patient care data—now had the potential to be fulfilled, as a federal mandate for the implementation of EHRs (electronic health records) was making the dream of interconnectivity around patient and patient care information, possible on a broad scale.

Fast-forward to 2019, though, and the key lesson learned in the HIE world has been this: without federal or state funds to sustain them long-term, or even with some funding, if it is very small, senior HIE leaders literally have to find ways to justify their existence; and many financial, operational, and governance models were shown not to work, or at least work well enough, in a sink-or-swim environment. Issues around whether individual physicians would pay fees remain difficult; but even more fundamentally, HIE leaders found that they had to offer services that had some market justification. And that’s just what the successful HIEs have done.

Importantly, a number of states—among them Maine, Michigan, Ohio, Indiana, and Florida—have had great experiences in the new (largely) self-sustaining HIE world, with statewide HIEs that have been thriving by providing key services that clinicians and patient care organizations, and health insurers, want—and will support in some way or another.

One of the most successful statewide HIEs has been CORHIO, the Colorado Regional Health Information Organization. Under the leadership of CEO Morgan Honea and a close circle of other senior executives, CORHIO has connected virtually all the acute-care hospitals in the state, as well as thousands of practicing physicians and other clinicians from across the state.

And, as I wrote earlier this week, “In that regard, Morgan Honea, CEO of CORHIO, the Colorado Regional Health Information Organization, a Denver-based HIE, will be one of several healthcare IT leaders participating in a roundtable discussion entitled, “How Colorado Is Redefining Interoperability,” and which will take place on Monday, July 15, during the Rocky Mountain Health Innovation Summit, sponsored by Healthcare Innovation, and which will be held at the Grand Hyatt Denver in downtown Denver. And on Tuesday, July 16, Honea will co-present with Dr. Timothy Dudley, Chief Medical Officer for Colorado Care Partners, a HealthONE accountable care organization (ACO) and clinically integrated network (CIN) that encompasses more than 320 clinicians, to share with the audience how their organizations are collaborating in order to meaningful data for their front-line care management initiatives, through the use of real-time notifications for hospital stays and emergency department visits in the ACO’s patient roster.”

One of the key building blocks in the collaboration with Colorado Care Partners, Honea told me, is that “We’ve developed a three-phase approach. It involves going into each of the practices and giving them access to our provider portal, so they can see the types of information going into CORHIO from the hospital setting without having to create new interfaces; and then we extract information from the clinical setting. The goal is that you’re not rip1ping and replacing technology.”

And that kind of work is key to the ongoing success of CORHIO: Honea and his colleagues are building infrastructures that serve very pointed, desired purposes among clinicians and patient care organizations. They’re providing services that providers really need and want.

And though it sounds simple, getting to that point is not at all easy, as the leaders of the successful HIEs (and those of the failed ones, too, if they’d be willing to talk) will tell you. In fact, being able to sustain success as an HIE is turning out to be an ongoing challenge. Yet, by providing real-time alerts and facilitating the sharing of key pieces of patient and patient care data in a very timely (and in some cases, real-time) way, is turning out to be the absolute critical success factor for HIEs—and some of the statewide HIEs have been among the most successful among U.S. HIEs.

I so look forward to hearing more from CORHIO’s Morgan Honea, and from Colorado Care Partners’ Dr. Timothy Dudley, next month, at our Healthcare Innovation Summit in Denver. It’s wonderful when leaders like them present and sit in discussion panels in front of a live audience; the connection and meaningful exchange that are generated are exciting to behold and to be a part of.

It will be great to present our entire program next month at the Grand Hyatt Denver, on July 15 and 16. Won’t you join us? Here’s a link to the full agenda. It’s going to be a particularly exciting time, with senior leaders from across the U.S. healthcare industry, including UC Health, Children’s Hospital Colorado, Intermountain Healthcare, and HIMSS. Personally, I can’t wait.

Meanwhile, the fact that CORHIO is doing so well says to me that long-term sustained success absolutely is possible for HIEs. The key is figuring out the critical success factors, and achieving them. There’s a long road ahead to truly comprehensive interoperability in U.S. healthcare, but organizations like CORHIO are showing the industry the way, every single day, byte by byte.

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