News | Information Technology | August 18, 2016

New Paper Proposes Strategies for Expanding HIE Participation

Financial incentives, value-added services and introduction of multiple HIE networks suggested as methods to encourage participation

HIE, health information exchanges, participation strategy, Binghamton University

August 18, 2016 — The U.S. healthcare industry has failed to create and sustain an efficient network for storing and sharing patient medical data, but a new proposed strategy could make the process easier and more affordable. The proposal was made by faculty at Binghamton University, State University of New York

“A patient’s medical history is often fragmented because people usually move from practitioner to practitioner, but their records don’t follow them,” said Emre Demirezen, assistant professor of supply chain management at Binghamton University. “Lack of coordination of care impacts both the patients and the providers in terms of time, money and health outcomes.”

In his new co-authored paper, Demirezen suggests ways for healthcare administrators and policymakers to encourage more providers to implement and use healthcare information exchanges (HIEs), which allow clinical information (medical history, family medical history, medications prescribed, disabilities and allergies) to be transferred electronically among healthcare providers. According to the paper, “HIEs will reduce duplication of tests; paper, ink and manual document printing needs; and phone calls and other follow-ups for test results.”

Demirezen said the long-term benefits of HIEs may be obvious to proponents, but problems related to cost, implementation and viability have been seldom explored by experts. He said that HIEs can be sustained financially by developing costing structures for HIE members. In regions where heterogeneity among health providers is high, meaning there is the presence of both large and small providers, he said there are several strategies to increase HIE participation:

Financial incentives — Financial incentives are one way to encourage hospitals and practitioners to use technology to log and transfer patient medical data. The paper suggests that HIE providers, whether they are a public or a private enterprise, should offer more incentives to help small health providers establish electronic health record systems at a very low cost or for free. Demirezen said that basic incentives alone would not entice all health providers to join a network when there are both large and small providers in the region.

Value-added services — Another way to increase participation in these exchanges is by offering more features, or value-added services, in addition to basic connectivity to an HIE. Examples of value-added services could be the use of an e-prescription tool or quality management portals. “Value-added services are one of the best possible business strategies for sustaining HIEs,” Demirezen said.

Multiple HIE networks — Demirezen also suggests that adding a second network in a region could increase the HIE participation among low-gain providers, or providers that will expect a low gain in terms of profit and value after joining an HIE.

“We found that having a second HIE in the same region that only focuses on low-gain providers could cause more providers to participate in the exchange,” he said. “Our research also suggests that certain providers would be more interested in participating in an HIE if the second HIE promises more value to them, such as offering electronic health record solutions for free or at a discount.”

Demirezen said that there is no question whether or not HIEs will improve healthcare systems, but making the HIEs financially stable is an integral part of the solution.

“It’s a matter of how the industry can make these exchanges financially viable and sustainable,” he said. “To deliver affordable, high-quality and efficient care, a physician or hospital needs the ability to obtain and transfer good information. HIE leverages technology to provide a continuum of care that is necessary to innovate the industry.”

Demirezen co-authored the paper with professors Subodha Kumar and Arun Sen of Texas A&M University. The paper, “Sustainability of Healthcare Information Exchanges: A Game–Theoretic Approach,” was published in Information Systems Research in June 2016.

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