Health industry exchanges more information, survey finds

eHealth Initiative

The number of health information exchanges that share information has nearly tripled during the past year, the eHealth Initiative Foundation reported Monday.

In the second annual survey of regional health information organizations, 25 respondents said their data exchanges were operational. Only nine were operational last year.

In addition, 40 organizations are far along in implementing their exchanges, though their systems do not yet exchange data. This group was the largest in this year’s survey.

However, the total number of health information exchanges (HIEs) grew only slightly from about 100 to 109. The report states that foundation officials “believe that there are likely many more HIE initiatives that did not complete the survey.”

The survey was posted on the eHealth Initiative’s Web site.

A little more than half of the exchanges said state governments were involved in their initiatives, usually through a Medicaid program or a public health agency.

Nearly half said they were counting on the federal government to provide grants and contracts, which are the biggest revenue sources of the exchanges. About one-quarter were using state and local government grants and contracts. Advances from hospitals were another major source of funding.

“A comparison of this year’s results to those from 2004 indicates a clear progression towards the use of funding sources outside of the federal government,” the report states.

Most of the exchanges are nonprofit corporations, the report states, and hospital officials and physicians are the most common participants in their governance. “The direct involvement of physicians in governance structures appears to be increasing as organizations and initiatives mature,” the report notes. At the same time, more of exchanges reported that multi-stakeholder collaborations were leading their exchange efforts, rather than a hospital or other health care provider.

The organizations that exchange data or are in advanced stages of implementation expect to share 15 kinds of data during the next six months. The most common data types are records of outpatient visits to care providers, laboratory test results and enrollment and benefits eligibility information.

Exchanges are expanding the services they offer, going beyond maintaining patient records and facilitating communications among health care providers, the foundation reported. For example, one-third are providing disease or chronic care management services, and that number will grow to one-half within the next six months.

According to the survey, 59 percent of the respondents indicated that securing upfront funding is a challenge, the great obstacle reported. Meanwhile, organizations added that accurately linking patient data and getting health plans involved in the exchange are also problems. Thirty-three percent of respondents listed each of those issues as a challenge.

The eHealth Initiative and its foundation are nonprofit organizations whose mission is to encourage the use of information technology to improve health care. Their offices are in Washington, D.C. The Health Resources and Services Administration, an agency in the Department of Health and Human Services, paid for the survey.