HIE Formation Part IV: Teaming for Success

By Laura Kolkman, RN, MS, FHIMSS, and Bob Brown

In this series of monthly articles, based in part on their recently published book, the authors discuss current HIE related events and leading practices within the context of forming an HIE initiative in your state, region or community. This series of articles was launched in the March 2011 issue of HIELights.

Now that you’ve begun seeking out and recruiting like-minded companions to join you on your journey of forming an HIE, it’s time to think about how you’ll organize and manage the effort. It’s not really necessary to get organized—some people seem to enjoy walking around in circles—but it is highly recommended if you intend to reach your declared destination. So, how do you move beyond your close knit exploratory committee or initial board?

One of the common attributes of successful HIEs is that the planning and formation stages were organized and run like a large-scale change management project – which is exactly what it is. Yes, there is a significant technology component but that should not be the focus of the project. Technology is an enabler, not the project’s main objective. The focus of the projects run by successful HIEs is promoting and enabling a change in the way people think about health information and how they actually use it. All of this should be done in the context of the IHI Triple Aim — simultaneous pursuit of three aims: better care for individuals, better health for populations, and lower per capita costs.

In our book, we recommend establishing and staffing five key workgroups to coordinate the necessary effort involved in starting up an HIE. These workgroups, which correspond to the five activity and competence domains we describe in detail in the book, are:

The Stakeholder Engagement & Participation workgroup will drive the organization’s activities to involve stakeholders and to maintain their engagement in the HIE. This group is also responsible for developing and driving the implementation of the communication plan.

The Governance workgroup will drive the formation of the legal and governing structures of the HIE.

The Business & Finance workgroup will lead the development of the strategic and business plans for the HIE.

The Privacy workgroup will develop the policies and procedures that are necessary to protect a patient’s health information.

Finally, the Technology & Security workgroup will design the overall technical architecture for the HIE, design the physical and technical security approaches, recommend the technology service model, evaluate vendor solutions, and recommend a technology vendor(s).

The initial tasks of each workgroup are to understand their charter, recommend refinements, and gain the board’s approval to move forward. A qualified workgroup leader should also be identified. As we indicate in our book, the leader may be a sitting member of the board.

With slight modification, this approach will also work to start up an ACO – once we have access to a clearer definition and a more compelling value proposition.

Laura Kolkman, RN, MS, FHIMSS, is the president of Mosaica Partners and Bob Brown is the vice president of Professional Services. Their book, The Health Information Exchange Formation Guide, was published by HIMSS in February. HIMSS companion website, where you can read chapter summaries and download select tables, figures, illustrations and checklists, is available at: www.himss.org/hieformationguide.