The Depressing State Of HIEs

Posted on May 3, 2012 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or

Ladies and gentlemen, I’ve been following the progress of HIEs since the mid-2000s, and the story has always seemed to be the same.  HIE gets sparked by a grant or some entrepreneurial thinking, gets to rolling, looks promising, then dies because there’s not enough cash to keep things working.

Seven or eight years later, I’d love to be telling y’all that the HIE has magically matured, and that regional HIEs are taking off rapidly now that it’s clear everyone will need to be part of one at some point.  Well, I’m afraid that even that modest hope — let’s forget the National Health Information Network — doesn’t look like it’ll be fulfilled soon.

The latest downer came from the National eHealth Collaborative (NeHC), a public-private partnership funded by ONCHIT.   While the report was apparently intended to help HIEs grow, it also did much to remind us of the obstacles facing most public HIEs.

As Chris Muir, state HIE project manager for ONC recently told a press conference, the $564 million in federal funds that have been laid out to date to jumpstart HIEs haven’t gotten the job done.  He noted that in many regions, infrastructure doesn’t exist to support HIEs, but even if it does, few providers sign up. Then, even if they sign up, most participants don’t take full advantage of the network.

And wouldn’t you know it, the growth of ACOs has ended up spiking some HIE projects. For example, a successful HIE noted in the NeHC report told the conference that ACO growth is hampering his organizations operations. Some ACO providers are now blocking access to their data so competitors can’t get to it, said CEO Tom Fritz.

There’s also some technical obstacles faced by the HIEs, but those, I must say, seem solvable in an era when people are already making determined strides to allow interoperability between HIEs and outpatient EMRs. One group of federally funded HIEs, the Beacon Communities, is developing a continuity of care document that can be automatically exported to an exchange via a pre-arranged trigger, said Jason Kunzman, Beacon Community senior project manager for ONC.

Well, this is all well and good. But I still think I’ll be keeping my basic medical info on a thumb drive for now.