January 28, 2019

By Mike Miliard, Healthcare IT News

IHIE’s John Kansky shares his perspectives on the value HIEs bring to national interoperability

Once upon a time, not too long ago, state and regional health information exchanges were really where it was at when it came to interoperability in the U.S. Earlier this decade, the betting was on those HIEs across the country to help build the infrastructure and use cases for nationwide data exchange.

That’s why programs such as ONC’s State HIE Cooperative Agreement Program disbursed $548 million to 56 awardees in 2010 to help them “develop and advance resources” for interoperability and, eventually, become self-sustainable. As we all know, many of them did just that – but many of them did not.

“That money came and went,” said John Kansky, president and CEO of Indiana Health Information Exchange, one of the HIEs that is still standing and self-sufficient. “Some of it was put to good use some of it wasn’t.

“But the reality is that as you look across the nation there are some states and regions with very good, very strong, very valuable health information exchanges, and there are some regions that have none,” he added. “Some regions have an HIE that still struggles to kind of find its value proposition – and therein lies, I think, the problem when you look from a national perch.”

But there is hope – and huge potential – for the HIEs still operating in the U.S. At HIMSS19 next month, Kansky, alongside Indiana Health Information Exchange COO Keith Kelley, will offer a presentation whose title paraphrases Mark Twain: “Said the HIE: ‘Reports of Our Death Are Greatly Exaggerated.'”

In recent years, a new nationwide model for interoperability and exchange has emerged and gained momentum, of course, this one largely driven by electronic health record vendors. Groups such as CommonWell Health Alliance and Carequality have built out membership, infrastructure and user base, gaining ground nationwide.

As they have, some in the industry may now give less thought to more traditional HIEs than they used to, said Kansky, or may criticize them for complexity and expense, failure to evolve with the times or develop more robust and sustainable business models.

Some of those criticisms may have merit, depending on the specific state or regional exchange being discussed, he admits. But the larger picture is more complex. In their HIMSS19 presentation, Kansky and Kelley will take a historical look at HIEs – describing why some failed and others have flourished. But they’ll also look to the future – highlighting the enduring value such exchanges can bring to the table, especially as they work in concert with other vendor-driven interoperability efforts.

“I want to be clear about our talk: It is not a couple of HIE guys getting on the stage and whining that no one appreciates us,” said Kansky. “Because half of our message is to the other HIEs – saying there is great opportunity for HIEs to deliver value if we adapt.”

More traditional HIE networks have a role to play in the current interoperability landscape, he said, and many will continue to evolve and demonstrate value for providers, payers and and vendors who partner with them – to say nothing of the patients who benefit from them.

Kansky recently offered some further thoughts on that topic with Healthcare IT News.