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eHealth Initiative Releases Results From 2009 Survey on Health Information Exchange
National Health Information Exchange Survey Shows Increased Activity, Cost Savings, Positive Impact on Physician Practices
More Initiatives Exchanging Data Leads to New Improvements in Quality and Returns on Investment
WASHINGTON DC (July 22, 2009) The exchange of health information electronically between physicians, hospitals, health plans, and patients has increased substantially in the last year and is reducing the cost of care and positively impacting physicians, according to a new survey released by the non-profit eHealth Initiative (eHI) today. “Migrating Toward Meaningful Use: The State of Health Information Exchange,” a report based on eHI’s Sixth Annual Survey of Health Information Exchange, includes responses from 150 community-based initiatives and shows a nearly 40 percent increase in the number of advanced or “operational” initiatives exchanging information. Responses from operational initiatives demonstrate an increasingly positive impact on the efficiency of care while showing a return on investment (ROI).
“The survey shows the potential for health information exchange to improve efficiency and reduce health care costs nationwide. We have real examples where care delivery was improved and cost savings found,” said Jennifer Covich, Chief Operating Officer and Interim CEO at eHI. “The American Recovery and Reinvestment Act could significantly impact health information exchange. Now more than ever, we need to focus on what works and direct resources that way.”
Click Here to Download the Full Report, "Migrating Toward Meaningful Use:
The State of Health Information Exchange" in PDF format.
SUMMARY OF KEY FINDINGS
In 2009, 150 initiatives across the country responded to and qualified for inclusion in the eHealth Initiative’s Sixth Annual Survey of Health Information Exchange. eHI identified 43 additional initiatives that are functioning, which did not complete the 2009 survey.* Overall, eHI has identified and collected information on 193 active health information exchange initiatives in the country.
When respondents completed this year’s survey the promise of the American Recovery and Reinvestment Act (ARRA) loomed large. The February 2009 enactment of ARRA provides much needed support to an industry that has struggled in a financially challenging landscape. The federal government is projected to spend at least $300 million in support of health information exchange activities in 2009 and 2010. While it is impossible to predict the impact of future funding, ARRA has helped energize the field in recent months.
Additionally, the new phrase that will redefine how health information technology is used—“meaningful use”—puts a strong emphasis on the ability of providers to exchange information in order to receive incentives from the federal government through Medicare and Medicaid payments. As this year’s report shows, health information exchange initiatives are developing capabilities that will be supportive of helping the nation’s clinicians and hospitals become meaningful users of electronic health records (EHR).
When eHI began tracking these initiatives six years ago, the field was immature, and only a handful of organizations were making progress. This year’s survey is a snapshot of a field learning from its mistakes, and a critical mass of organizations struggling to make health information exchange successful and sustainable. The field of health information exchange continues to face familiar challenges, but as the results of this year’s survey show, steady progress is being made across the country to improve care and reduce costs. Highlights from the report are listed below:
The number of initiatives involved in health information exchange is growing.
* Sixty-seven health information exchange initiatives responded to the eHI survey for the first time.
* There are at least 193 active initiatives involved in health information exchange.
o 150 initiatives responded to the survey.
o eHI identified 43 additional initiatives from the 2008 survey which are still functioning, but did not complete this year’s survey.
The number of organizations that reported being operational has sharply increased.
* Fifty-seven health information exchange initiatives reported being operational in 2009 up from 42 initiatives in 2008, a nearly 40 percent increase from 2008.
Health information exchange has had a positive impact on physician practices allowing them to become more efficient without disrupting care.
* Operational initiatives report the following impacts for practices that utilize the exchange:
o Improved access to test results and resultant efficiencies on practice (28 operational initiatives).
o Improved quality of practice life (i.e., less hassles looking for information, getting home sooner at the end of the day, etc) (24).
o Reduced staff time spent on handling lab and radiology results (23).
o Reduced staff time spent on clerical administration and filing (22).
Health information exchange can help reduce costs for a number of different stakeholders, but hospitals and physician practices could see the greatest return on investment (ROI).
* In 2009, operational initiatives most often reported ROI from hospitals (21) and physician practices (19).
Operational health information exchange initiatives are helping cut health care costs in a number of areas.
* Primary reported areas of cost-cutting include:
o Reduced staff time spent on handling lab and radiology results (26 operational initiatives).
o Reduced staff time spent on clerical administration and filing (24).
o Decreased dollars spent on redundant tests (17).
o Decreased cost of care for chronic care patients (11).
o Reduced medication errors (10).
The services most offered are results delivery, connectivity with electronic health records, clinical documentation, and alerts for providers.
* Results delivery (e.g. laboratory or diagnostic study results) (44 initiatives).
* Connectivity to electronic health records (38).
* Clinical documentation (34).
* Alerts to providers (31).
* Electronic prescribing (26).
More health information initiatives are exchanging data, with increases in the type of data exchanged nearly across the board.
* The number of initiatives currently exchanging data:
o Laboratory data increased to 49 initiatives, up from 26 in 2008.
o Medication data (including outpatient prescriptions) 48 initiatives are currently exchanging.
o Outpatient laboratory increased to 45, up from 25 in 2008.
o Outpatient episodes increased to 43, up from 23 in 2008.
o Radiology results increased to 39, up from 23 in 2008.
o Emergency Department episodes increased to 36, up from 27 in 2008.
Health information exchange initiatives are less dependent upon federal funding.
* Seventy-one initiatives reported they are not dependent on federal funding, up from 64 initiatives in 2008. The number of organizations which state they are dependent on federal funding checked in at 30 initiatives, only one more than in 2008.
* Ninety respondents hope or expect to receive funds through the American Recovery and Reinvestment Act.
For the first time in six years, initiatives identified “addressing privacy and confidentiality issues” as the most pressing challenge they face, surpassing “developing a sustainable business model”.
* The most significant challenges impacting health information exchange initiatives today are:
o Addressing privacy and confidentiality issues – HIPAA and other (93 initiatives identified this as a pressing challenge).
o Defining the value that accrues to the users of the health information exchange (92).
o Developing a sustainable business model (90).
“One of the greatest challenges has been our ability to spread best practices in health information exchange,” added Covich. “Cost savings and improved quality of care need to be better documented, so we can replicate what works and help create a health care system that connects clinicians and providers. We have a great opportunity to expand HIE efforts with the new funding coming out in 2009 and 2010 through the Recovery Act. We need to take advantage of this moment in time, when health information technology and health information exchange enjoy broad support. We might not get another.”
A report of this breadth would not have been possible without the contributions of many individuals and many organizations. Enormous thanks go to Jennifer Covich Bordenick, Brett Andriesen, Brian Wagner, Claudia Ellison, Alyssa Monsen, Danielle Brooks, and Kelly Sherman for their contributions. These individuals played a considerable role in the development of the survey, collection of results, data analysis and the writing of this report.
Our sincere thanks also go to the co-chairs of eHI’s Connecting Communities Workgroup: Micky Tripathi, PhD, President and Chief Executive Officer, Massachusetts eHealth Collaborative, and J. Marc Overhage, MD, PhD, President and Chief Executive Officer, Indiana Health Information Exchange. Thank you also to the co-chairs of eHI’s Privacy Work Group: Deven McGraw, Director, Health Privacy Project, Center for Democracy and Technology, and Gerry Hinkley, Partner, Davis Wright Tremaine. Assistance was also provided by Tom Fritz, CEO, Inland Northwest Health Services, and Trudi Matthews, Director of Policy and Public Affairs, HealthBridge. Rachel Block, Deputy Commissioner, Office of Health Information Technology Transformation NYS Department of Health and Robert D. Marotta, Esq., Senior Vice President and Regulatory Counsel, HLTH Corporation/WebMD, provided exceptional leadership to the organization throughout the development of this report.
Finally, special thanks to Axolotl, which provided support for the dissemination of survey results.
*eHI staff reached out to respondents from the 2008 survey that did not complete the 2009 survey. Staff was able to confirm that 43 initiatives are still functioning.
More Initiatives Exchanging Data Leads to New Improvements in Quality and Returns on Investment
WASHINGTON DC (July 22, 2009) The exchange of health information electronically between physicians, hospitals, health plans, and patients has increased substantially in the last year and is reducing the cost of care and positively impacting physicians, according to a new survey released by the non-profit eHealth Initiative (eHI) today. “Migrating Toward Meaningful Use: The State of Health Information Exchange,” a report based on eHI’s Sixth Annual Survey of Health Information Exchange, includes responses from 150 community-based initiatives and shows a nearly 40 percent increase in the number of advanced or “operational” initiatives exchanging information. Responses from operational initiatives demonstrate an increasingly positive impact on the efficiency of care while showing a return on investment (ROI).
“The survey shows the potential for health information exchange to improve efficiency and reduce health care costs nationwide. We have real examples where care delivery was improved and cost savings found,” said Jennifer Covich, Chief Operating Officer and Interim CEO at eHI. “The American Recovery and Reinvestment Act could significantly impact health information exchange. Now more than ever, we need to focus on what works and direct resources that way.”
Click Here to Download the Full Report, "Migrating Toward Meaningful Use:
The State of Health Information Exchange" in PDF format.
SUMMARY OF KEY FINDINGS
In 2009, 150 initiatives across the country responded to and qualified for inclusion in the eHealth Initiative’s Sixth Annual Survey of Health Information Exchange. eHI identified 43 additional initiatives that are functioning, which did not complete the 2009 survey.* Overall, eHI has identified and collected information on 193 active health information exchange initiatives in the country.
When respondents completed this year’s survey the promise of the American Recovery and Reinvestment Act (ARRA) loomed large. The February 2009 enactment of ARRA provides much needed support to an industry that has struggled in a financially challenging landscape. The federal government is projected to spend at least $300 million in support of health information exchange activities in 2009 and 2010. While it is impossible to predict the impact of future funding, ARRA has helped energize the field in recent months.
Additionally, the new phrase that will redefine how health information technology is used—“meaningful use”—puts a strong emphasis on the ability of providers to exchange information in order to receive incentives from the federal government through Medicare and Medicaid payments. As this year’s report shows, health information exchange initiatives are developing capabilities that will be supportive of helping the nation’s clinicians and hospitals become meaningful users of electronic health records (EHR).
When eHI began tracking these initiatives six years ago, the field was immature, and only a handful of organizations were making progress. This year’s survey is a snapshot of a field learning from its mistakes, and a critical mass of organizations struggling to make health information exchange successful and sustainable. The field of health information exchange continues to face familiar challenges, but as the results of this year’s survey show, steady progress is being made across the country to improve care and reduce costs. Highlights from the report are listed below:
The number of initiatives involved in health information exchange is growing.
* Sixty-seven health information exchange initiatives responded to the eHI survey for the first time.
* There are at least 193 active initiatives involved in health information exchange.
o 150 initiatives responded to the survey.
o eHI identified 43 additional initiatives from the 2008 survey which are still functioning, but did not complete this year’s survey.
The number of organizations that reported being operational has sharply increased.
* Fifty-seven health information exchange initiatives reported being operational in 2009 up from 42 initiatives in 2008, a nearly 40 percent increase from 2008.
Health information exchange has had a positive impact on physician practices allowing them to become more efficient without disrupting care.
* Operational initiatives report the following impacts for practices that utilize the exchange:
o Improved access to test results and resultant efficiencies on practice (28 operational initiatives).
o Improved quality of practice life (i.e., less hassles looking for information, getting home sooner at the end of the day, etc) (24).
o Reduced staff time spent on handling lab and radiology results (23).
o Reduced staff time spent on clerical administration and filing (22).
Health information exchange can help reduce costs for a number of different stakeholders, but hospitals and physician practices could see the greatest return on investment (ROI).
* In 2009, operational initiatives most often reported ROI from hospitals (21) and physician practices (19).
Operational health information exchange initiatives are helping cut health care costs in a number of areas.
* Primary reported areas of cost-cutting include:
o Reduced staff time spent on handling lab and radiology results (26 operational initiatives).
o Reduced staff time spent on clerical administration and filing (24).
o Decreased dollars spent on redundant tests (17).
o Decreased cost of care for chronic care patients (11).
o Reduced medication errors (10).
The services most offered are results delivery, connectivity with electronic health records, clinical documentation, and alerts for providers.
* Results delivery (e.g. laboratory or diagnostic study results) (44 initiatives).
* Connectivity to electronic health records (38).
* Clinical documentation (34).
* Alerts to providers (31).
* Electronic prescribing (26).
More health information initiatives are exchanging data, with increases in the type of data exchanged nearly across the board.
* The number of initiatives currently exchanging data:
o Laboratory data increased to 49 initiatives, up from 26 in 2008.
o Medication data (including outpatient prescriptions) 48 initiatives are currently exchanging.
o Outpatient laboratory increased to 45, up from 25 in 2008.
o Outpatient episodes increased to 43, up from 23 in 2008.
o Radiology results increased to 39, up from 23 in 2008.
o Emergency Department episodes increased to 36, up from 27 in 2008.
Health information exchange initiatives are less dependent upon federal funding.
* Seventy-one initiatives reported they are not dependent on federal funding, up from 64 initiatives in 2008. The number of organizations which state they are dependent on federal funding checked in at 30 initiatives, only one more than in 2008.
* Ninety respondents hope or expect to receive funds through the American Recovery and Reinvestment Act.
For the first time in six years, initiatives identified “addressing privacy and confidentiality issues” as the most pressing challenge they face, surpassing “developing a sustainable business model”.
* The most significant challenges impacting health information exchange initiatives today are:
o Addressing privacy and confidentiality issues – HIPAA and other (93 initiatives identified this as a pressing challenge).
o Defining the value that accrues to the users of the health information exchange (92).
o Developing a sustainable business model (90).
“One of the greatest challenges has been our ability to spread best practices in health information exchange,” added Covich. “Cost savings and improved quality of care need to be better documented, so we can replicate what works and help create a health care system that connects clinicians and providers. We have a great opportunity to expand HIE efforts with the new funding coming out in 2009 and 2010 through the Recovery Act. We need to take advantage of this moment in time, when health information technology and health information exchange enjoy broad support. We might not get another.”
A report of this breadth would not have been possible without the contributions of many individuals and many organizations. Enormous thanks go to Jennifer Covich Bordenick, Brett Andriesen, Brian Wagner, Claudia Ellison, Alyssa Monsen, Danielle Brooks, and Kelly Sherman for their contributions. These individuals played a considerable role in the development of the survey, collection of results, data analysis and the writing of this report.
Our sincere thanks also go to the co-chairs of eHI’s Connecting Communities Workgroup: Micky Tripathi, PhD, President and Chief Executive Officer, Massachusetts eHealth Collaborative, and J. Marc Overhage, MD, PhD, President and Chief Executive Officer, Indiana Health Information Exchange. Thank you also to the co-chairs of eHI’s Privacy Work Group: Deven McGraw, Director, Health Privacy Project, Center for Democracy and Technology, and Gerry Hinkley, Partner, Davis Wright Tremaine. Assistance was also provided by Tom Fritz, CEO, Inland Northwest Health Services, and Trudi Matthews, Director of Policy and Public Affairs, HealthBridge. Rachel Block, Deputy Commissioner, Office of Health Information Technology Transformation NYS Department of Health and Robert D. Marotta, Esq., Senior Vice President and Regulatory Counsel, HLTH Corporation/WebMD, provided exceptional leadership to the organization throughout the development of this report.
Finally, special thanks to Axolotl, which provided support for the dissemination of survey results.
*eHI staff reached out to respondents from the 2008 survey that did not complete the 2009 survey. Staff was able to confirm that 43 initiatives are still functioning.
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