HIE Formation Part XIII: Why Are You Doing This?

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

Laura Kolkman, RN, MS, FHIMSS  
Bob Brown

In this series of monthly articles, the authors, based in part on their recently published book, discuss current HIE-related events and leading practices within the context of forming an HIE initiative in your state, region or community. This is Part 13 of the series. You can access previous installments at the HIELights e-newsletter archives.

After all the time and effort you’ve expended so far in forming your HIE, two reasonable questions to ask are, “What’s your objective?” and, “What’s in it for you?” But don’t answer yet. We’ll come back to those questions—and give you our opinion—at the end of this month’s column.

First, let’s look at what others might say about the journey you’re on.

Some would say it’s simply about standing up an organization that can serve the needs of your community. When it’s operational, your HIE will have the requisite business plan, policies, governance model, leadership, technical architecture, procedures and staff to get the job done. You’ll have built the organizational engine that will enable the exchange of patients’ health information in a safe and secure manner. But is that all?

Some would say that standing up an organization is only the first step; that it’s really about getting the information flowing. With enough of the right kind of information flowing, the healthcare providers that link with your HIE will be able to get up-to-date information about their patients’ encounters with other providers and other members of the healthcare ecosystem. Those providers will have access to more – and hopefully better – information about their patients than they do now. But is that all?

Still others would say that with access to more and better information, those providers will be able to have a more holistic view of the state of their patients’ health, both individually and collectively. They’ll be able to have a more accurate picture of the health of the people for which they are accountable. They’ll be able to reduce the number of tests they order and make sure that when they refer one of their patients to a specialist or to a hospital that the patient’s up-to-date information will be available. But is that all?

A number of people would say that your organization’s ability to provide anonymized and aggregated information is the real objective. Providing this information to state and local health departments will aid in their efforts in biosurveillance and in responding to the outbreaks and spread of epidemics. Is there more?

Yes, much more. There are scores of individual objectives that will be realized with the establishment of HIEs. What will happen when a critical mass of those objectives have been met? We will finally have the information we now lack. Only when the necessary and sufficient information is readily available – concerning an individual or a community or a region or a state—will we be able to use it to develop the type of rational and fact based programs we need to significantly improve the quality of healthcare delivery and substantially reduce the costs commonly associated with missing data, duplicative testing and fraud.

What’s in it for you? Better health and wellness care for you, your family, your community and beyond. Less unnecessary expenses being paid—directly or indirectly—by you, your community and the population at large.

We think it’s a worthwhile objective.
Laura Kolkman, RN, MS, FHIMSS is the President of Mosaica Partners and Bob Brown is the VP of Professional Services. Their book—The Health Information Exchange Formation Guide—was published by HIMSS in February 2011, and was the winner of the 2012 Book of the Year Award. View the HIMSS’ companion web site to read chapter summaries and download select tables, figures, illustrations and checklists.