Establishing A National HIE On One Platform May Be A Good Idea

Posted on March 21, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

When you read this statement from HIT vendor Orion Health, it sounds oh-so-simple: why not establish an entire county’s HIE network on a single connecting platform?  Given the country’s already high EMR adoption rate — about 80 percent of GPs had one, as of March 2010 — New Zealand’s already part-way there.  Just knit offices up together and you’re ready to go.

Orion, of course has its own technology in mind, naturally. But whatever vendor you use, they may be onto something. I’ll pause here to say that the following proposal could incite a riot at a HIMSS floor full of competing vendors, but hey, ideas are harmless, aren’t they?

What if CMS decided that it would pay incentives not just to meaningfully, sensitively, insightfully install EMRs, but to connect them to an overall HIE?  And to take the thought into more controversial territory, what if it had a vendor or two of choice which doctors and hospitals had to use if they wanted the dough?

As we all know, the value of EMR installations isn’t just in automating, error checking and (hopefully) streamlining workflow in practices. The data is infinitely more valuable when it can be aggregated, shared, cross-checked and mined for best practices.

What are the odds of that, however, if you have an outbreak of regional and state projects using technology from a multitude of vendors?  You can talk standards all you want, but true interoperability isn’t going to happen anytime soon this way.  National connectivity?  Well, give me a couple of decades and let’s see how far that’s gotten.

On the other hand,  if CMS signed contracts with HIE technology vendors, and demanded that they give preferred pricing to those work with them, you’d see a rash of connectivity unrivaled since the invention of the telephone.  Before you scream that this just isn’t fair, doesn’t this kind of thing happen every day in, say, military contracting?

I know, I know, this may not be practical. But you can’t argue that It’d be interesting to see how the HIE and EMR market gelled if CMS took a strong lead.