Information Exchanges Show Signs of Progress

The national effort to establish a network of health information exchanges could streamline health care costs and provide medical professionals with more timely and accurate patient information, by electronically merging information between physicians, laboratories, pharmacies and hospitals.

The goal is to have less paperwork, less duplication of services, better patient outcomes and to lower costs for everyone. 

Health information exchanges have received a lot of media attention recently, but exchanges have been operating around the country for the past seven years. And the number of those information exchanges has been steadily rising every year, both nationally and in California.

A new survey of health information exchanges shows that the model is a workable one, but one that needs greater participation to ensure success, according to Jennifer Covich Bordenick, CEO of the eHealth Initiative, which conducted the study.

“We’ve seen that these things can work,” Bordenick said. She added that health information exchanges and the rate of their success “have gone up dramatically in the last year.”

According to the eHealth Initiative survey, there are now 73 operational exchanges across the country, six of which are in California. Of those up-and-running exchanges, 18 have actually passed the break-even barrier and become sustainable — and one of those sustainable exchanges is in California.

In looking at this year’s survey, Bordenick said she hoped to see a single common marker of success this time around, but that proved elusive.

“We did not find the sustainable organizations to have that single factor that makes them work,” she said. “There is not that one business model that will guarantee success. We can’t say, if you do this, you will be successful.”

But what Bordenick said they did find is that participation among diverse stakeholders is vital, whatever business model the exchanges use.

“It’s like roads that are connecting doctors to lab to hospital to pharmacy,” she said, adding that the more avenues of commerce that are open, the more likely the exchange will succeed.

The nascent statewide efforts to establish health information exchange networks are known as State Designated Entities, or SDEs. They are the conduit for federal funds from the American Recovery and Reinvestment Act.

The SDEs could learn a few things from the established information exchanges around the country, Bordenick said. That’s partly because the experimental nature and futuristic quality of these exchanges is about over, she added.

“It’s about time now,” Bordenick said. “There is money there, there is funding there. And now it’s just about time. It’s true, you can’t throw money at exchanges and get them to work, you need participation, and many of these [exchanges] took two or three years to set up properly.”

So if the statewide health information exchanges can learn anything from the local consortiums, she said, it’s this: “The groups that are sustainable involve all the doctors, the labs, the consumers, pharmacies. Everyone’s at the table,” Bordenick said.

“They focus on a small set of data — they don’t try to boil the ocean. They do one thing and do it well, then do another and do it well. They bring together a diverse group of all of the stakeholders.”

The full report is available online.