Five Questions to Ask Before Joining an HIE

"An HIE is right for every practice,” said John Kansky, president and CEO of the Indianapolis-based Indiana Health Information Exchange (HIE). “Perhaps it’s even a necessity, though needs will vary from practice to practice.” Launched in 2004, the Indiana HIE network connects more than 30,000 healthcare providers in 17 states.

Kansky said HIEs are helpful for both primary-care and specialist practices alike, but there’s a certain amount of due diligence any practice should undertake with their HIE provider.

His first recommendation for any small- to medium-size physician practice is to work through HIMSS’ Evaluating HIE/Health Information Organization (HIO) Opportunities. There are also five questions you must ask before joining an HIE. Here they are:

How could access to an HIE help your practice?

“Today, you’re a primary-care physician and you’re calling specialists to find out what happened with your patients,” said Kansky. “You’re asking to have their clerk send over your patients’ lab results.”

“If I put myself in the shoes of a primary-care physician, I don’t have time to think about the HIE. I know what I need,” he said. “I need to get information from specialists about my patients. I need to be aware that my patients have been admitted to the hospital.”

How important is it to your practice to receive lab and radiology reports?

One of the most important things for primary-care practices is the time it takes to get lab and radiology reports and hospital discharge summaries into their EHR, said Kansky. For a specialty practice, having access to an HIE can translate into access to vital patient information.

According to Kansky, easy access to patient information becomes really important for the patient-physician interaction, since it can cut down on the time it takes for the patient to bring the specialist up to speed during the initial consultation.

Do you want to actively pull reports into your EHR or do you want to have them show up automatically?

“In Indiana, we have a centrally managed HIE that provides access to a virtual community health record for patients,” said Kansky. “We’re in a good position to help specialists and primary-care providers with access to contextual clinical information about their patients and other patients.”

He said it can get more difficult if the local HIE doesn’t have a repository -which is reasonably rare -but it could put the practice in a position where it needs to broker exchanges of information between referring physicians and primary-care physicians.

It can get a lot more fuzzy and complicated if you need to ask the primary-care provider to push the information from their EHR to your specialty practice’s EHR, he said.

What are the HIE’s capabilities and costs?

Practices need to ask the HIE if they can deliver lab results and patient information into their EHR and how much that costs, he said. They also need to find out how easy it is to access information about new and current patients.

What else does a practice need to consider before joining an HIE?

“Find out about what the HIE in your area is offering,” said Kansky. “Figure out what value you can glean. If they’re not doing it right and if it doesn’t fit into your EHR’s workflow, gripe and tell them what you need. It’s hard enough to practice medicine and the HIE gives the practice one more thing to do.”