Hospital-Backed HIE On The Rocks

Posted on January 2, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

In an all-too-familiar tale of conflict, turf wars and financial doubts, a three-year effort to bring some of the Chicago area’s largest hospitals into an HIE seems on the verge of collapse.

The proposed HIE is backed by the Metropolitan Chicago Healthcare Council, a nonprofit group of about 150 hospitals and healthcare providers. But despite industry backing, the effort hasn’t gotten any momentum. Though the Council has been flogging the HIE concept since 2009, just 18 hospitals and physician groups have agreed to join, according to a report in Crain’s Chicago Business.

In theory, the massive, sophisticated health systems that serve the Chicagoland area would see the value in sharing medical records if anyone would. If nothing else, they’re doubtless thinking about or already participating in risk-bearing ACO contracts, so cutting down on needless duplicated tests would be a plus.

But apparently, potential HIE members are balking at the cost of sustaining the HIE, which can run to six figures annually depending on the institution. Apparently, they’re not sure that they’ll get a decent return on their investment. And of course, there’s little doubt that these systems are already investing many, many millions in EMRs and supporting systems, tying up most if not all of their IT investment budget.

What’s more, while Crain’s doesn’t mention this issue, I’d argue that hospitals are also skittish about cooperating with their competitors. Particularly in an intensely competitive market like Chicago, hospitals and health systems may feel that HIEs are a step too close to the enemy.

Now, even if the major hospitals refuse to invest in the HIE, the Council does have other ways that it might be able to pay for the exchange.  For one thing, the group has begun discussions with health insurers to see if they might be interested in helping to fund it. And there’s always government grants, which are available to help kick off startup HIEs.

The bottom line, though, is that hospitals are still conflicted when it comes to HIE involvement. Though most CIOs say that they’re interested in being involved, financial — and let’s not forget competitive — issues prevent them from getting on board.