Challenges, alternatives, and paths to sustainability for health information exchange efforts

Joshua Vest, Thomas R. Campion, Rainu Kaushal

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Health information exchange (HIE) is a promising approach to improving the cost and quality of healthcare. We sought to identify the strengths and weaknesses of organizational models to achieve exchange, and what can be done to ensure the sustainability and effectiveness of exchange efforts. We interviewed state and national health informatics policy experts (n = 17). Data were collected as part of an evaluation of the Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) program and included respondents from both the private and public sectors. Data were analyzed using a general inductive and comparative approach with open coding of themes. Interviewees generally viewed HIE as a public or societal good to be valued. However, they identified challenges with the regional health information organization (RHIO) model of facilitating exchange including: economics, organizational issues, and geography. RHIOs were contrasted against alternative methods of exchange such as Direct, enterprise HIE, and vendor-mediated exchange. HIE is a difficult undertaking due to political and economic reasons. Alternatives to the RHIO model have features that may be more attractive to participants, but may be of less public benefit. Using states as intermediaries and mandating exchange under public health law may avoid the challenges facing exchange efforts. Moving forward, policies will have to address the shortcomings of each HIE model to ensure information is effectively shared between providers to maximize health benefits.

Original languageEnglish (US)
Article number9987
JournalJournal of Medical Systems
Volume37
Issue number6
DOIs
StatePublished - Dec 1 2013
Externally publishedYes

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Sustainable development
Health
Economics
Organizational Models
Organizations
Geography
Informatics
Private Sector
Quality of Health Care
Public Sector
Insurance Benefits
Health Policy
Public Health
Health Information Exchange
Delivery of Health Care
Costs and Cost Analysis
Public health
Health care
Costs
Industry

Keywords

  • Governance
  • Health information exchanges
  • Policy
  • Public health
  • Regulatory issues

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Information Systems
  • Health Informatics
  • Health Information Management

Cite this

Challenges, alternatives, and paths to sustainability for health information exchange efforts. / Vest, Joshua; Campion, Thomas R.; Kaushal, Rainu.

In: Journal of Medical Systems, Vol. 37, No. 6, 9987, 01.12.2013.

Research output: Contribution to journalArticle

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