Neal GangulyKate Berry, CEO, National eHealth Collaborative (Washington, D.C.) was quick to bring up e-prescribing as what she calls an example of a successful form of HIE. E-prescribing took a number of years to gain physician adoption, but it now exceeds 50 percent of all U.S. physicians, Berry says.The second most frequently mentioned way an HIE can go wrong, according to the Blueprint Healthcare IT survey, was viewing HIE interoperability as just a technology issue. Tracy Rue, senior consultant, Health IT Transformation, BluePrint Healthcare IT, says interoperability is a huge resource issue, with organizations struggling to marshal the right people, tools, and vendors to get the necessary work done.Chilmark Research’s Moore is seeing in the market now a lot of HIE implementations of results and orders delivery going into rip-and-replace mode. “I think now we’re getting to another level of interoperability in the market, and we’re looking at really trying to drive those patient records to get that true longitudinal record together to drive a higher level of care and quality,” he adds.Other HIE pitfalls named by respondents were security and access management issues, as well as syncing priorities and technology architecture and setting clear goals. HIEs that span state boundaries and hospitals with non-employed medical staff can only exacerbate these challenges, says Ganguly.
Strategic VisioningAs was documented in the
NeHC HIE Roadmap, to avoid some of these pitfalls, great care needs to be taken in the visioning and strategic planning of the HIE and its initial roadmap, which needs to be revisited on a scheduled basis. “Building stakeholder trust and achieving ongoing alignment around the vision and objectives is critical, especially given potential conflicts inherent among stakeholder groups,” the NeHC report stated.Berry emphasizes that HIEs can’t sustain on grant funding alone, and the real driver for compelling change in the market will be the move toward value-based payments. In order to survive, HIEs must have a strong business orientation, in which all stakeholders who are getting value are also contributing financially to its sustainability, she adds. Subscription-based fees have seen more success in the industry, rather than transaction fees, which have the tendency to discourage use, Berry says.