Why I’ve Got the Blues Over HIE

Aug. 8, 2014
At a time when HIE is at a crossroads, two rival health insurers in California are putting their differences aside and putting down significant seed money to connect providers within the state. For that reason, I'm ecstatic and I've got the Blues.

Right now, health information exchange (HIE) is in a bit of a weird place.

Federal funding from the Health Information Technology for Economic and Clinical Health (HITECH) Act for cooperative statewide health information exchanges (HIE) programs has ended or is ending. The dust is settling. It’s like the Wild West. Who survived? Who didn’t? States like Massachusetts and North Carolina are finding ways to thrive in the soon-to-be post-federal-grant period. Other states are not faring as well and I'm guessing more are likely to fall by the wayside. 

That’s not to say the concept is dead in those states. It’s just going to be an uphill climb without publicly funded HIEs. Many times, private HIEs struggle to expand due to technological issues, competing funding organizations not seeing the return on investment (ROI), or they’re simply not willing to work with one another.  

In this time of uncertainty, I was psyched to see some exciting news coming out of California this week. In case you missed it, Blue Shield of California and Anthem Blue Cross are putting $80 million into a statewide HIE project that will cover nine million patients off the bat. It immediately will make this exchange one of the largest HIEs in the country when it becomes operational by the end of the year.

The HIE, called the California Integrated Data Exchange (Cal INDEX), will use both clinical data from providers and claims data from payers. Their goal is to connect at least 30 large medical provider organizations by the end of three years, with those providers funding the HIE through subscription fees. Already, Dignity Health, a Sacramento-based health system with more than 30 hospitals in the state, has committed to participate. The providers will be connected through a portal that displays data, alerts, and analytics and that works with most major electronic medical record (EMR) systems, the two insurers say.

It's an ambitious effort. It's certainly not guaranteed success and in many ways, is no different than any other large HIE initiative. It will need to overcome the same challenges of interoperability, data security, and proving sustainability that other HIEs are facing. 

What I love about this initiative is Blue Shield of California and Anthem Blue Cross--two rivals in the insurance market, it should be noted--are providing enough money to make the HIE operational for three years. Three years! With the right governance and structure, this is more than enough time to prove ROI for the lagging doubters. 

There was a great quote in a Wall Street Journal article on this initiative from Jennifer Covich Bordenick, CEO of the eHealth Initiative: "We are really at a crossroads now. It's up to the private sector to step in and take over where the federal government left off." 

Everyone talks about the importance of HIE and being able to share data across health systems, county lines, and state borders. Few organizations though seem to want to put their money where their mouth is. And so few have the desire to work with competing organizations for the greater good. The Blues in California are doing just that and for that reason, I've got the Blues. 

Please feel free to respond in the comment section below or on Twitter by following me at @GabrielSPerna

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