A few years ago, health information exchanges faced yawning obsolescence. Now the COVID-19 pandemic has rocketed these information-sharing networks back to relevancy.
The pandemic transformed the perception of HIEs and fostered an appreciation of their value, spotlighting the importance of sharing population-level data quickly, with HIEs across the country crunching data to answer hospital capacity questions, predict the virus’ spread and, now, determine vaccine allocation and eligibility.
While HIEs have always been helpful for solving immediate and unexpected care concerns related to natural disasters or flu outbreaks, the increasing number of value-based relationships, a laser focus on the social determinants of health and HIEs’ 2020 moment in the sun have offered the shot in the arm some say was needed.
The HIE revival raised a few old questions surrounding these systems. Namely, what business model helps them achieve sustainability? When it comes to interoperability, which is preferred: point-to-point solutions that are more efficient, or hub-and-spoke models that are more realistic?
“COVID has had a big impact on perception and brand,” said Claudia Williams, CEO of Manifest MedEx, a statewide health information system in California. “If you think about trying to create a layer of the healthcare stack that we don’t compete over, and if you look at interoperability in a broader sense of, ‘What does the country need for healthcare data interoperability?’ you absolutely need an intermediary and you probably need an intermediary with some normalized data repository.”
This debate has come to a head in California, where Manifest MedEx advocates are calling on legislators to incentivize and mandate provider and payer participation in the network, foster a stronger connection with the state, and increase public funding in the exchange.
Proponents want the California HIE to operate as a public data utility, or a not-for-profit that connects and coordinates the activities of the state’s many disjointed regional exchanges to solve public health needs. But providers like Kaiser Permanente are questioning the necessity of building out yet another tool to exchange patient data.
“It’s public health, it’s equity, it’s Medicaid transformation, it’s improving healthcare value in the state. I don’t think anyone can argue that this infrastructure isn’t needed to do that,” said Williams, who served as a senior adviser for health technology and innovation to the White House during the Obama administration and was also director of health information exchange at HHS.