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1
2019 HIE Survey
DRAFT RESULTS – 4.16.19
2
Background on Survey
▪ Administered February 19, 2019 – April 12, 2019 through SurveyMonkey Link
▪ Responses fielded through Constant Contact and personal Microsoft Outlook emails. eHIstaff made numerous follow-up calls to those on list.
▪ Almost 90 initial respondents
▪ 53 validated for completeness andname/title/organization
▪ Still reviewing data
Demographics of Respondents
3
DRAFT – Preliminary Results
States Participating in Survey
4
States with at least one respondent
DRAFT – Preliminary Results
Organizational Structure (Self-Described)
5
20
12
2
32
Organizational Structure Choices
Responses (Could select more than one)
Regional or community 60% 32
State-designated 38% 20
Private/Proprietary 23% 12
Hybrid 4% 2
DRAFT – Preliminary Results
How many payers participate in your exchange?
6
20
12
2
32Number of Payers
in HIE Responses
0 15% 8
1 -3 34% 18
4-10 38% 20
11 or more 13% 7
DRAFT – Preliminary Results
How many members are represented by payers in the HIEs?
7
20
12
2
32
7
8
18
20
20
7
Answer Choices Responses
< 1 Million 34% 18
1 - 3 Million 23% 12
More than 3 Million but less than 5 Million 9% 5
5 - 10 Million 15% 8
> 10 Million 0% 0
Not sure 19% 10
Answered 53
8
Respondents Organized by Participating Payers
Zero
▪ Clinical Connect HIE
▪ CommunityHealth IT
▪ HealthLINC
▪ HealthLinkNY
▪ Lewis and Clark Information Exchange
▪ Lincoln Land HIE
▪ Rio Grande Valley HIE
▪ SCHIEx
1-3
▪ Coastal Connect HIE
▪ ConnectHealthcare
▪ DHIN
▪ etHIN
▪ healtheConnect Alaska
▪ HealtheConnections
▪ HealthInfoNet
▪ Idaho Health Data Exchange
▪ Iowa HIN
▪ Massachusetts eHealth Institute
▪ Mass HIway
▪ North Dakota Health Information Network
▪ Paso del Norte HIE
▪ Quality Health Network
▪ Rochester RHIO
▪ South Dakota Health Link
▪ UP Health Care Solutions
▪ Wyoming Department of Health
4-10
▪ CORHIO
▪ Great Lakes Health Connect
▪ HASA
▪ Hawaii HIE
▪ HEALTHeLINK
▪ HealthShare Exchange
▪ Indiana HIE
▪ Keystone HIE
▪ Kansas HIN
▪ Michiana HIN
▪ MO Health Connection
▪ MyHealth Access Network
▪ NEHII
▪ New Mexico Health Information Collaborative
▪ Ohio Health Information Partnership
▪ Arkansas Office of HIT
▪ OneHealthPort
▪ San Diego Health Connect
▪ Utah HIN
▪ West Virginia Health Information Network
11 or More
▪ Agency for Health Care Administration
▪ CRISP
▪ Greater Houston Healthconnect
▪ Health Current
▪ Healthix
▪ The Health Collaborative
▪ WISHIN
9
Respondents Organized by Number of Members
Less than 1 million
▪ Arkansas Office of HIT
▪ CommunityHealth IT
▪ ConnectHealthcare
▪ etHIN
▪ healtheConnect Alaska
▪ HealthInfoNet
▪ HealthLinkNY
▪ Idaho Health Data Exchange
▪ Iowa HIN
▪ Michiana HIN
▪ New Mexico Health Information Collaborative
▪ North Dakota Health Information Network
▪ Paso del Norte HIE
▪ Quality Health Network
▪ South Dakota Health Link
▪ UP Health Care Solutions
▪ Wyoming Department of Health
▪ West Virginia Health Information Network
1-3 million
▪ HASA
▪ Hawaii HIE
▪ HealtheConnections
▪ HEALTHeLINK
▪ Kansas HIN
▪ Massachusetts eHealth Institute
▪ Mass HIway
▪ MyHealth Access Network
▪ NEHII
▪ Rochester RHIO
▪ Utah HIN
▪ WISHIN
3< and >5 million
▪ CORHIO
▪ Indiana HIE
▪ OneHealthPort
▪ San Diego Health Connect
▪ The Health Collaborative
5-10 million
▪ Agency for Health Care Administration (FL)
▪ CRISP
▪ Greater Houston Healthconnect
▪ Health Current
▪ Healthix
▪ HealthShare Exchange
▪ Keystone HIE
▪ Ohio Health Information Partnership
Not Sure
▪ Clinical Connect HIE
▪ Coastal Connect HIE
▪ DHIN
▪ Great Lakes Health Connect
▪ HealthLINC
▪ Lewis and Clark Information Exchange
▪ Lincoln Land HIE
▪ MO Health Connection
▪ Rio Grande Valley HIE
▪ SCHIEx
Business Drivers & Challenges
10
DRAFT – Preliminary Results
Biggest Business Drivers
11
20
12
2
32
7
8
18
20
20
7
Answer Choices Responses
Desire of stakeholders to manage risk and deliver on value-based care contracts 58% 31
Easier integration through APIs, FHIR, etc 47% 25
Provide clear value to end users such as care transition management and medication reconciliation 47% 25
Incentives from government agencies including CMS, state, and local authorities 34% 18
Increased demand for population health analytics tools 32% 17
DRAFT – Preliminary Results
"Value-based care trends influence my decisions about technology adoption."
12
20
12
2
32
of respondents somewhat or completely agree with this statement
92%
DRAFT – Preliminary Results
Top Priorities inNext Two Years
13
Answer Choices Responses
Enhance interoperability 47% 25
Support value-based care 43% 23
Integrate EMR and HIE workflows 40% 21Integrate non-traditional types of data like genomics and social 34% 18
Enhance care coordination 34% 18
Long term sustainability, financial viability 32% 17
DRAFT – Preliminary Results
Top Challenges Rated Significant or Very Significant
• Price/Cost (88%)
• Competing priorities (78%)
• Enhanced utilization and optimization of the solution (75%)
• Adaptability of the technology (61%)
• Technical Challenges (43%)
14
DRAFT – Preliminary Results
Technology Budgets Increasing
• 74% said their technology budget will likely increase over the next two years
• 14% said it will decrease
• 12% said no change
15
Integrating Claims & Clinical Data
16
DRAFT – Preliminary Results
How many HIEs have the capability to integrate claims and clinical data?
17
60% able to integrate
DRAFT – Preliminary Results
How many HIEs have the capability to integrate claims and clinical data?
18
85% of the 3-10 million group (n=12) are able to integrate
DRAFT – Preliminary Results
How many HIEs have the capability to integrate claims and clinical data?
19
Half of the 3 million and below group (n= 30) are still unable to
integrate clinical and claims data
DRAFT – Preliminary Results
Top Challenges Rated as Significant or Very Significant
20
• Data quality issues (60%)• Cost of technology (58%)• Availability of qualified staff (53%)• Claims data not available (46%)• Privacy/Security policies that limit
transactions (43%)
DRAFT – Preliminary Results
Have Seen a Significant or Very Significant Increase in Demand From
Payers for More Access to Clinical Data
21
67%
Services Offered
22
DRAFT – Preliminary Results
Technology Currently Already Adopted
23
We have already adopted this technology
Provider alerts 77% 40
HIE to HIE exchange 72% 38
Care coordination tools 40% 21
E-referrals/E-consults 21% 11
All payer claims database 15% 8
Medication reconciliation 11% 6
Remote patient monitoring 6% 3
DRAFT – Preliminary Results
Services Likely to be Offered in Next Two Years
24
Not likely or Not very likely Somewhat likely
Likely or Very Likely
We have already adopted
this technology
Provider alerts 2% 0% 19% 77%HIE to HIE exchange 4% 2% 19% 72%Care coordination tools 4% 11% 40% 40%E-referrals/E-consults 6% 28% 30% 21%All payer claims database 21% 15% 19% 15%Medication reconciliation 8% 30% 34% 11%Remote patient monitoring 40% 13% 17% 6%
DRAFT – Preliminary Results
The Services they are Providing to Payers are Valuable or Very Valuable
25
84%
Data Exchanged
26
DRAFT – Preliminary Results
Deep Dive – Care Coordination
Care Coordination is a priority for all size groups• HIEs in the 5-10 million members group have already
adopted this (88%) (n=8)
• Only a quarter of the 3-5 million members group have already adopted, but the remaining 75% are likely or likely to offer the service in the next two years (n=5)
• Only a quarter of the 1-3 million members group have already adopted, but another half are likely or very likely to adopt in the next two years (n=12)
• The less than 1 million members group is ahead of the game with 41% already adopting coordination and 59% reporting they are likely or very likely to adopt (n=18)
27
DRAFT – Preliminary Results
Deep Dive – All Payer Claims Database
• 63% of the 5-10 million members group have already adopted this and 25% are somewhat likely to adopt in the next two years (n=8)
• None of the HIEs in the 3-5 million members group have already adopted but half are likely or very likely to offer, while the other half are not likely or not very likely (n=5)
• Very few of the less than 3 million members group have already adopted (7%), and only 13% are likely or very likely to offer in the next two years. 50% said they are not very or not likely to adopt in the next two years (n=30)
28
DRAFT – Preliminary Results
Deep Dive –Remote Patient Monitoring
• Of the 5-10 million members group, only 29% have already adopted this and 14% will be likely or very likely to offer in the next two years. Overwhelmingly, 57% say they are not likely or not very likely to offer (n=8)
• 100% HIEs in the 3-5 million members are not likely or not very likely to adopt remote patient monitoring in the next two years (n=5)
• 50% of those in the less than 3 million members group are also not likely to adopt in the next two years (n=30)
29
DRAFT – Preliminary Results
Size Matters in Behavioral Health Data Exchange
30
▪ Of the HIEs whose payers represent up to 3 million members, two-thirds (66%) are experiencing difficulty in exchanging behavioral health data (n=30)
▪ 75% of HIEs with a bigger proportion of members represented by payers (3-10 million) did not report behavioral health data as difficult to exchange (n=12)
DRAFT – Preliminary Results
Quality Reporting Less Difficult for Smaller HIEs
31
▪ Half of HIEs with 3-10 million members represented by the payers in their exchange (50%) are having difficulty exchanging quality reporting data (n=12)
▪ Of the HIEs whose payers represent up to 3 million members, very few are having difficulty with this data (13%) (n=30)
DRAFT – Preliminary Results
Social Determinants of Health Data is Hard
32
▪ Across all organization sizes, HIEs are experiencing difficulty in exchanging Social Determinants of Health (SDOH) Data (52%)
DRAFT – Preliminary Results
Deep Dive - Medications Filled
33
▪ A larger proportion of HIEs with 5-10 million members represented by payers (50%) are having trouble with medications filled data compared with those in the less than 1 million group (33%); 1-3 million group (25%); and more than 3 million but less than 5 million group (25%)
DRAFT – Preliminary Results34
Radiology imaging studies are less difficult. Only 15% report difficulty
exchanging this data.
Progress in Exchanging Radiology Images
Other Points
35
DRAFT – Preliminary Results
Predicted Impact of TEFCA on Interoperability
• 60% said significant or very significant
• 25% said somewhat significant
• 15% said not significant or not very significant
36
DRAFT – Preliminary Results
Participation in SHIEC, eHealth Exchange, Direct Trust, SHIEC PCDH, Carequality,
and CommonWell
37
20
12
2
32
Answer Choices Responses
SHIEC 85% 44
eHealth Exchange 79% 41
Direct Trust 69% 36
SHIEC Patient Centered Data Home (PCDH) 58% 30
Carequality 15% 8
CommonWell 6% 3
None of the above 4% 2
Answered 52
Skipped 1
DRAFT – Preliminary Results
Next Steps
• Answer additional questions from Orion
• Finalize cleaning raw data
• Drafting conclusions about the data
• Preparing report – within two weeks
• Identify speakers from respondent list
38