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ONC focuses on HIEs for data sharing

Health information exchanges could provide the interoperability backbone between providers and state and public health agencies, making real-time data readily available in times of crisis.

The Office of the National Coordinator for Health IT will award $2.5 million in funding to health information exchanges to improve and expand healthcare data collecting and sharing services.

Don Rucker, national coordinator for health IT, said health information exchanges (HIEs) could act as a healthcare data network for providers and as a resource for integrated data reporting, including test results and patient demographic information, that could prove critical during crises such as the COVID-19 pandemic. HIEs play instrumental roles in communities by collecting information from multiple points of care, data Rucker said will help public health agencies support communities disproportionately impacted by the pandemic as well as future health events.

Don RuckerDon Rucker

ONC will allocate the $2.5 million it received from the Coronavirus Aid, Relief and Economic Security (CARES) Act in five cooperative agreements of up to $500,000 each to HIEs under a federal program that aims to improve HIE infrastructure. Agreements will be awarded by end of September.

Recipients will be required to deploy services that increase health information exchange at the state and local levels. They will have to include a diverse set of participating providers that care for more at-risk populations, as well as focus on communities hard-hit by the pandemic such as older adults and those with disabilities. Rucker said HIEs could provide greater opportunity for a one-stop shop when it comes to receiving reported data from communities.

"Right now, we have a lot of different mandated reporting because of the pandemic," Rucker said Monday during a fireside chat at the virtual ONC Tech Forum. "But I think, over time, we can move to that more integrated reporting where then the public health agencies get a feed from the HIEs. We're not there yet, but I think that's a big opportunity."

CIOs and health information exchanges 

Healthcare CIOs and other C-suite decision-makers are at the forefront of establishing relationships with HIEs, which allow providers to electronically share and access a patient's medical information across the continuum of care.

These exchanges operate under different funding models, including as nonprofit state or regional organizations that receive federal funds as well as private business models paid by participating providers. There are approximately 100 HIEs in the U.S. that cover 99% of the population.  

The Indiana Health Information Exchange, which gets its funding from participating providers, makes information from hospitals, small clinical practices, laboratories, payers and other healthcare services available to 50,000 providers in Indiana and surrounding states. It has more than 15 million patients' information stored in the HIE.

Shaun GrannisShaun Grannis

When establishing a relationship with a new healthcare system, Shaun Grannis, M.D., chief medical information officer at the Indiana Health Information Exchange, said he speaks directly with healthcare CIOs and others in the C-suite about what partnering with an HIE looks like, what it will take to implement data interfaces to exchange data and how patient data is managed and secured.

Being very clear about value propositions, how data is going to be secured and what value it brings to the [provider] is very important in that relationship-building activity.
Shaun GrannisCMIO, Indiana Health Information Exchange

"The critical success factor is building a fabric of trust," Grannis said. "Typically, if you approach people to join an HIE, the first questions are, 'Who are you, why do you want my data and what's in it for me?' Being very clear about value propositions, how data is going to be secured and what value it brings to the [provider] is very important in that relationship-building activity."

A significant function of an HIE's technical infrastructure is collecting, standardizing and aggregating clinical data from multiple providers and other healthcare services, such as laboratories. Grannis said data standardization continues to be a challenge for providers and is often a question he fields from CIOs, which is why most HIEs have become involved in regulatory data standardization efforts, such as the Fast Healthcare Interoperability Resources (FHIR) healthcare data standard framework.

HIEs also provide greater data sharing capabilities through collaboration with other HIEs. They come together through initiatives and organizations like the Strategic Health Information Exchange Collaborative to better collaborate with HIEs from across the country and help providers share data across state lines and with other healthcare systems. Through this initiative, the Indiana Health Information Exchange connects HIEs from Ohio, Kentucky, Tennessee and Michigan.

Grannis said steps from federal agencies, including this new push by ONC to award HIEs with federal funds to build out the necessary data-sharing infrastructure, should be incentive for CIOs to consider how to use HIEs across the care continuum as part of their interoperability strategy.

"As the healthcare system in the United States becomes more interoperable, more digital, health information exchanges can be a partner to clinical organizations who are increasingly having to connect across organizational boundaries," Grannis said. "HIEs have been doing this for years, they have a great deal of expertise not only in the technical and business aspects of it, but also the regulatory aspects."

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