Hospitals Plan HIE Spending Binge, But Are They Prepared?

Posted on September 17, 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

Here’s some stats that wowed me, and may surprise you too. It looks like hospitals, under pressure to move towards meeting Meaningful Use Stage 2 expectations, are finally barreling into investments in HIE technology.

According to a new study by CapSite, 71 percent of hospitals  surveyed plan to purchase new HIE technology, and 50 percent have joined a private, state or regional HIE. The CapSite 2012 U.S. Health Information Exchange Study, which surveyed about 370 hospitals on their plans, noted that these stats show an uptick from 2011, where they found that one-third of hospitals had joined an HIE.

Why do these stats seem remarkable to me?  Well, for one thing, they’re spending a lot of money to do something nobody seems to know how to do well. To quote a previous story for this blog:

The question is, and has been for many years, whether those investments offer any financial or clinical payback. After all, you can only lay out that kind of money for so long before there’s no business case for the exchange.

Unfortunately, it looks  like the answer may still be “no” in many cases, according to the authors of a study appearing in Perspectives in Health Information Management. Of the 96 HIEs that responded to the researchers’ survey, the “vast majority” didn’t have a business model in place that would sustain itself even into the near future.

It’s not that there aren’t roadmaps for hospital HIE builders to consider. Earlier this year, for example, the National eHealth Collaborative and IDC Health Insights released reports offering best practices HIE builders should consider.

But if you look closely at these recommendations, as well as others made by analysts and policy makers, it appears the HIEs are going to have to get past lots of political obstacles. The NeHC’s step one, “reaching a consensus with regard to objectives and vision for the exchange” could be a real trial in and of itself.  Getting to the point where hospitals share governance effectively with other bodies, deal with competitive issues and handle interoperability — well, I’m not going to hold my breath.

So, while HIE fans (and vendors, natch) are likely to be cheered by this report, I’m calling this out as a potential disaster. Hospitals, are you really ready to spend HIE money wisely?