New Texas HIE agreement aims to end decades of data silos

Decades of fragmentation across Texas HIEs

Historically, HIEs in Texas have operated independently, creating pockets of information that limited statewide visibility into patient encounters.

According to Hoag, providers connected with multiple notification services to get full notification coverage. Health plans also built their own "single pipe" connections to hospitals, bypassing HIEs when data proved unreliable or incomplete. This resulted in numerous networks delivering partial data, and duplicate alerts that were limited in their usefulness for care coordination.

"You don't go to the bakery for a bag of flour, you go for a croissant. What I feel like what we've been delivering has been ingredients," said Beckett. "Providers… don't want to connect to 50 different places and then have to go put it in their own baking machine and make something useful out of it."

What unified access means for providers, patients and payers

By pooling the ADT feeds of both networks, THSA and C3HIE expect to give providers more complete encounter data and reduce the administrative burden of maintaining multiple connections.

Studies show that more complete data improves healthcare delivery, leading to better outcomes. Unified access directly supports value-based care models, which depend on efficient, timely notifications to track outcomes, coordinate care transitions and prevent avoidable utilization.

"If we can get data to help providers take care of their patients, then we're going to pass that along," Hoag said.

However, making data more actionable is essential, Beckett added.

"Our mission is not to share data. That's a mechanism to improve healthcare outcomes and reduce costs. We only do that by people using the data," he said.

One man's vision of interoperability

The data exchange agreement fundamentally changes the way HIEs do business in the state.  Now, Beckett reports, HIEs will no longer have to compete based on the data they can provide.

"As a provider, I don't have to pick one or the other for the data that I get. I'm [deciding based] on services,"  he said.

Hoag added that Beckett's vision for interoperability was a driving factor to move the agreement forward.

"Phil [Beckett] discussed reciprocal data sharing between the regionals [in open board meetings]. If you're sharing all your data with THSA, then THSA would share back," Hoag said.

Both leaders acknowledged that breaking down silos is necessary for long-term sustainability.

"It doesn't financially help either of our organizations in the short term," Beckett said. "But the long-term goal is strength in Texas and what we can do for patients and physicians and hospitals and payers. Health plans want single pipes of data… They'll work around the HIEs in Texas."

With the new agreement in place, payers may no longer need workarounds to access complete data.

From agreement to reality

The HIEs expect implementation to move quickly, with leaders targeting a launch as early as January. Beckett said the work ahead is straightforward. Hoag agreed, noting, "Sharing ADT messages is one of the simpler things that we do."

Tasks to get up and running include reconciling patient rosters and finalizing governance and privacy mechanisms under existing business associate agreements.

Another priority is preventing duplicate notifications for providers that are connected to both networks.

"C3 and THSA will coordinate on that and say… 'Do you want your notifications from THSA or do you want them from C3?'" Beckett said.

Both HIEs will rely on continuous communication with participants to resolve issues as they arise.

"We're very engaged with these participants together and we'll ask them, 'Are you getting duplicates?'" Beckett said.

He added, "I was just on a call yesterday with a group… they were getting duplicates, and we got to the root of it and who's going to do the filtering."

Several broader challenges remain. Beckett highlighted patient-consent complexity, saying, "I'd like to simplify so patients don't have to opt in and out at 20 different places."

The agreement marks a significant shift toward more unified data access and reduces the need for providers to choose between incomplete networks.

"A provider shouldn't have to make decisions to either connect to multiple places or go short on data," Beckett said.

Hoag added that the partnership "really will impact outcomes and cost savings," positioning the HIEs to reduce confusion and strengthen care coordination across the state.

Elizabeth Stricker, BSN, RN, comes from a nursing and healthcare leadership background, and covers health technology and leadership trends for B2B audiences.