Almost anything is potentially negotiable, particularly for a highly valued HIE partner. Thus items like fees and governance structure should not be considered written in stone.
Health departments are unique organizations within the community and can bring many types of value to an HIE organization. These values may include, among others:
- neutral convening
- population-level data
- access to public health funding
HIE grant funding opportunities, for instance, may depend on health department participation. Public health participation is also needed to ensure that healthcare providers can earn Meaningful Use incentives.
This is a good point for the health department to assess if it wants to purchase HIE services, invest in exchange or join an exchange organization as a strategic partner - or all three. Public health investment or commitment might be reciprocated by a prominent role in governance, and/or discounted participation fees or costs for interface and interoperability services.
The health department and HIE service provider should assess the many ways in which each party can provide value to the other, and use that information to establish a division of costs and benefits that will be appropriate and sustainable to both.