Fake News, once referred to as “yellow journalism”, emphasizes sensationalism over substance. It’s nothing new and has probably been around since cave men carved the first painting on their living room wall. This was a big issue during the 2016 U.S. Presidential election. Fake news stories about the candidates proliferated on the internet, with little regard for truth or journalistic standards. This kind of disinformation obscures actual facts and makes complex topics even harder to understand.
The problem is not limited to the political sphere. Sensationalism finds its way into reporting on professional disciplines too. As an occasional series, we would like to take the opportunity to unpack some of the topics that we see as “fake news” in Health Information Exchange.
Part 1 – HIEs Are Failing
Back in 1989, New York Magazine first published the phrase “if it bleeds, it leads” in a story written by reporter Eric Pooley. It describes the news industry’s tendency to publish negative news more prominently than positive stories. This seems often to be the case where Health IT and Health Information Exchange are concerned.
To be fair, there has been no shortage of bad news to report. Early development of HIE was mainly driven by federal incentive grants. It was a lot like the gold rush days of the Wild West. States were given broad latitude in how to structure their exchanges, with limited oversight from the government. Grant dollars were awarded with little more than the assurance of connecting providers, and minimal requirements for sharing data. In many cases, sound business practices and principles were overlooked or even ignored. As the government subsidies began to run out, it became clear that “striking it rich” with a successful and sustainable Health Information Exchange was easier said than done. There were high profile and costly failures in Nevada, Connecticut, Illinois, and elsewhere. The ripple effects made payers and providers hesitant to engage in data sharing, which fueled the narrative that Health Information Exchange, as a concept, was doomed to fail.
In early 2017, Coordinated Care Oklahoma (CCO) announced that it would cease operations. COO was the largest HIE in the state of Oklahoma. The reasons for its closing are nuanced and were missed in many news stories. In late 2016, their chief competitor signed an agreement with the largest health plan in Oklahoma. This contract mandates that providers MUST submit data through the competing HIE to take part in value-based contracting and pay-for-performance incentives.
COO recognized that providers and hospitals would have to pay duplicate fees to support both organizations. In the best interests of their members, their leadership made the difficult decision to dissolve and to assist participants in transitioning to the competitor’s network. COO is not closing its doors because HIE, as a concept, is a failure or because of a lack of value delivered to their customers. Rather, they are victims of market dynamics common to any competitive growth industry.
The healthcare system as it exists took decades to build and is extremely complex. By comparison, electronic Health Information Exchange has been around fewer than 10 years. Passage of the Affordable Care Act radically changed the traditional practice of healthcare delivery and finance. The industry is still figuring out what exactly those things will look like in a value-based system. It is not realistic to expect that Health IT can simply flip a switch and have a functional model that works for every stakeholder across the healthcare ecosystem. The perception that Health Information Exchange is struggling to live up to its promise discounts the massive progress that has been made in a relatively short time, and the rapid evolution that continues. In the words of Mark Twain, “The reports of my death have been greatly exaggerated.”
There are many examples that highlight the progress that is being realized by HIE pioneers across the country:
- Ohio based Clinisync Health Information Exchange is live with nearly 150 offices who are able to share lab results, radiology reports, and transcribed documents bidirectionally. In addition, more than 400 LTPAC providers are in the process of connecting to Clinisync’s network.
- The Delaware Health Information Network (DHIN) is the nation’s first fully statewide health information exchange. DHIN provides an electronic network through which hospitals, physicians, laboratories and other clinical entities quickly and securely exchange clinical results and reports. All 46 hospitals and 96% of healthcare providers in the state exchange data through DHIN.
- CORHIO, the Colorado Regional Health Information Organization, announced in 2015 that the number of participating health care users and data available in their network had grown by 111% and 118% respectively. This milestone marked the third consecutive year of triple-digit growth for the organization.
- Our own organization, Great Lakes Health Connect (GLHC), is the leading Health Information Exchange in Michigan. We seamlessly and securely facilitate the transmission of more than a billion messages annually across 129 health systems, and nearly 4,000 primary, secondary, and allied care provider offices across the state.
Health information exchange organizations across the country are not simply sustaining, they are thriving. They play an integral role in ushering in a new era for healthcare delivery that is patient focused, high quality, and value driven.