Top Ten Ways an HIE Can Go Wrong OR Using HIE to Deliver on the Promise of Connected Care
#1 Underutilization of HIE portal by physicians
If physicians aren’t using an HIE to track, transmit and request information then the whole concept falls apart. In order to avoid this:
- Find champions
- Listen to potential value propositions
- Maintain a face with HIE
- Celebrate utilization! Engage your users and keep incentivizing and investing in them and their usage.
#2 Equating HIE interoperability as just a tech issue
The HIE and EMRs will take care of security, access management and consent issues. On-boarding and off-boarding give access to positions that are not usually visible to the outside world. On Auditing process: certain HIE vendors are better with audit reports than others. If we fail at taking care of these privacy issues then that will speak poorly when we build them across the country. Sub-acute rehab stays for instance, are protected by state law from being transmitted without direct patient consent.
#3 Trusting HIE to take care of security and consent issues
There was one woman who was discharged from a hospital and came home with 50 different medications – that she didn’t need. Their total cost was about $16,000 for a single fill. This occurred because hospitals, primary care physicians and various specialists all had different lists for what medications she should be taking and had no communication between each other for validation.
#4 Having architecture and strategic priorities out of async
#5 Lacking a clear mission for HIE
HIE Standards and Protocols. What kind of technology can you utilize to solve the problem? Are there design patterns we should be leveraging in order to accomplish our short term goals while allowing for future advances to build upon the foundation we’re laying now? HIE should really be a backbone to help you realize your transformation objectives.
#6 Waiting to implement analytics, data management solutions until maturation
#7 Using HIE to solve physician alignment, patient engagement problems
#8 Identifying which practices to connect first
An HIE is only as strong as its weakest link. Without adoption from both large hospitals and small practices it won’t be effective as an exchange.
#9 Rushing to get practices connected to share orders, labs
#10 Thinking HIE solutions are all the same
Every HIE solution is completely unique from technical implementation to funding & sustainability to overall workflow. Different states have specific laws regulating healthcare and the flow of information. Some states require patients to opt-out to information, others require patients to opt-in. Not every payer is in every state, and for every state they do work in specific agreements have to be made regarding funding.
Panel: Eric E. Smith, Sandi Selzer, and Colleen Woods