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Health, technology and other organizational professionals with desires to implement a thriving and successful health information exchange (HIE) should start by remembering the parts of speech they learned in elementary school.
There’s HIE as a verb. And HIE as a noun. In the same way each needs to work together to craft a meaningful sentence, each also needs to work together to create a workable, sustainable, productive and collaborative HIE that securely shares comprehensive patient information to improve care, treatment and outcomes.
In simple terms, HIE as a verb describes the “science” and HIE as a noun the “art” of health information exchange, although there is certainly crossover. Perhaps it’s more accurate to say that HIE as a verb is more technology-dependent – literally, it’s the act of exchanging information to deliver better patient-centric care. HIE as a noun describes the slightly softer, but equally or more important issues such as governance, policy, legislation, trust and collaboration that are all necessary to provide a successful HIE framework.
One without the other makes innovative HIE impossible. Without cooperation and governance (HIE as a noun), mere connectivity and information exchange (HIE as a verb) will lack direction, scope and purpose. Conversely, without the “verb” – a secure, rapid, comprehensive, scalable, sustainable, seamless, easy-to-use and reliable network of information exchange – HIE as a noun is reduced to an inert set of principles and guidelines without an effective delivery system. Something like a glossy owner’s manual describing a car without an engine.
HIE science: The verb
In the current state of HIEs today, the science – the verb – is a bit ahead of the art. The technology is already available, for example, to implement electronic health records – the foundation of HIE technology – and to analyze collective administrative and clinical data to predict outcomes and determine the most cost-effective treatments. At Ingenix we advocate that clients make HIE part of a robust “health cloud” computing database platform, by integrating analytics and other services, improving the clinical workflow, and transforming data and information into knowledge.
The next step for the “science” (the verb) is to introduce intelligence into our technology solutions, so we can not only do simple things, such as reducing the number of duplicative tests, but we could actually go to a provider and say, “Here’s the information on your patient’s health from all sources, and the treatment options that have proven most effective with similar patients.”
HIE art: The noun
But for this to work, we need to also pay attention to HIE as a noun. All of the technology goals and possibilities I’ve outlined can’t happen without collaboration, openness, respect and trust among stakeholders. Provider organizations, governments, State Designated Entities (SDEs) and communities will all have to believe that any HIE effort has their interests, and the interest of patients, at heart. Patients and physicians, too, will have to be able to trust that the information they disclose is secure and that patient privacy will be safeguarded – not merely as a matter of protective technology, but as an ongoing and high-priority part of HIE policy and governance.
All of this will require strong HIE leadership and a decision-making process whose essential elements include advance planning, flexibility, transparency, open communications and teamwork. We repeatedly hear from clients about the need for these qualities in virtually all the work we do with government agencies, physicians, hospitals, commercial payers and virtually every other healthcare entity. But they become even more critical in the fledgling “HIE era” as we work to reduce friction and tension across the healthcare ecosystem. This kind of cooperative spirit is new to the industry, but indispensable if we are to make real progress.
Verb + noun = HIE success
Together, the science and the art – the verb and the noun – have enormous potential. A sustainable, successful HIE requires each level to work smoothly and work in tandem. No small task, but one that can produce transformative results if it’s carried out properly.
Think about it. A well-managed, patient-focused HIE can help bring about better access to and quality of care, reduce costs, improve outcomes, define meaningful use measures, provide comparative effectiveness information to physicians and patients, and encourage data-based predictive modeling to increase the emphasis on preventative care.
And along the way, a well-run HIE can also bolster the credibility of, and increase the trust in, the entire healthcare system.
All of this from a noun and a verb working together – connect the parts of speech properly, and you will create an enduring HIE success story.
