Better Outcomes. Delivered.
04/10/2023 Copyright ©2012 Indiana Health Information Exchange, Inc. 1
Health Information Exchange (HIE) Sustainability: Lessons Learned by the Indiana Health Information Exchange
John P. Kansky, MSE, MBAVice President – Strategy and PlanningIndiana Health Information Exchange
www.ihie.org
The Indiana Health Information Exchange
• Founded in February 2004• Based on the technology,
knowledge, and experience of the Regenstrief Institute
• 75 employees• Non-grant revenue in excess of $5
million annually• Participation from 93 hospitals (30
health systems), 19,000 clinicians, and 5 payors
• Serving an area with a population of approximately 4 million people
Copyright © 2011 Indiana Health Information Exchange, Inc
www.ihie.org
The Soapbox and the Green Eyeshade
There are services that a health information exchange could theoretically provide for which there is no apparent business model. There are also services that have business models that are outside the mission of a typical HIE.
Stuff an HIE could do to help “save the healthcare system”
Stuff an HIE could do that someone will pay for
Services on which you can
base a sustainable
Health Information
Exchange
The Soapbox
The Green Eyeshade
Copyright © 2011 Indiana Health Information Exchange, Inc
www.ihie.org
HIE Sustainability – Basic Conceptual Principles
Based on the experience of 8 years of operation and an on-going history of service development, launch, and support, IHIE bases its sustainability plans seven basic principles. We believe these principles are key to health information exchange being a self-sustaining endeavor.
• Principle 1: HIE is a Business• Principle 2: The Leveraging of High-cost, High-value Assets • Principle 3: No Loss Leaders• Principle 4: Independent, Local Sustainability• Principle 5: Natural Monopoly• Principle 6: The Need for Scale• Principle 7: Avoidance of Grants for Operational Cost
Copyright © 2011 Indiana Health Information Exchange, Inc
www.ihie.org
Principle 1: HIE is a Business
HIE is a business and as with all businesses, creating a sustainable HIE requires:
• offering services that the market wants… • at a price the market will bear… • doing so in such a way that revenue exceeds
expenses. • services delivered by the HIE must be at a
level that healthcare organizations have come to expect from their suppliers.
Copyright © 2011 Indiana Health Information Exchange, Inc
www.ihie.org
Patient
Physician
Physician
Physician
Hospitals
Payors
Physician Offices
Labs / Imaging Centers
Public Health
Outpatient Rx
Health Information Exchange
Data Repository
Network Application
s
Data Stewardship
Hospitals
Payors
Physician Offices
Public Health
Labs / Imaging Centers
Researchers
• Results Delivery• MU Support• Public Health
Integration
• Results Delivery• MU Support• Clinical Quality
Services• Community Health
Record Access
• Results Delivery
• Community Health
Record System
• Biosurveillance• Reportable
Conditions• Results Delivery
• Quality Reporting• Physician Bonus
Administration
• De-identified, longitudinal clinical
data
Copyright © 2012 Indiana Health Information Exchange, Inc
Health Data Sources Value-Added Services
www.ihie.org
Copyright © 2012 Indiana Health Information Exchange, Inc
Patient
Physician
Physician
Physician
Hospitals
Payors
Physician Offices
Labs / Imaging Centers
Public Health
Outpatient Rx
Health Data Sources
Health Information Exchange
Data Repository
Network Application
s
Data Stewardship
Hospitals
Physician Offices
Public Health
Labs / Imaging Centers
Researchers
Value-Added Services
• Results Delivery
• MU Support• Public Health
Integration• Results Delivery
• MU Support• Clinical Quality
Services• Community
Health Record Access
• Results Delivery
• Community Health
Record System
• Biosurveillance• Reportable
Conditions• Results Delivery
• Quality Reporting• Physician Bonus
Administration
• De-identified, longitudinal clinical
data
™
Public Health Emergency Surveillance
System (PHESS)
www.ihie.org
The Leveraging of High-cost, High-value Assets
Layer I: Including Interface Engine, Community Trust, …
Layer II: Including Mapped/Normalized Data…
New Value-added Service
Layer III: Including Repository Services…
New Value-added ServiceMedication
Profile
Public HealthSurveillance
Clinical Messaging
Clinical Quality Services
Ambulatory Results Review
ED Abstract and Results
ReviewNew Value-added Service
Inpatient Results Review
Value-added services that can be built upon the HIE investment
A layer of necessary investment
HIE assets are interdependent and, once created, can be leveraged to deliver additional services.
Copyright © 2011 Indiana Health Information Exchange, Inc
www.ihie.org
Problem to Solve
Solution Byproduct Issue
Secondary Solution
Outcome
George Washington Carver(early 1900’s)
Soil depleted by Cotton
Plant Peanuts to replenish lost nutrients in the soil
What to do with all the peanuts?
Make and sell products that use peanuts, e.g.: • Peanut butter• Peanut oil
Sustain the southern economy (Keep growing cotton)
HealthInformation Exchange(2012)
• Rising cost of healthcare• Need to improve healthcare quality and safety
Build HIEinfrastructure (and use it to address the problems)
How does society (or a given community) pay for HIE? i.e. financially sustain it
Offer/sell services that use (and reuse) the HIE infrastructure, e.g.:• Electronic Results delivery• Clinical Quality Services• Medication profile
Make positive contributions to health and healthcare
Copyright © 2011 Indiana Health Information Exchange, Inc
The Peanut Butter Principle
www.ihie.org
Questions?
For Further Information, Please Contact:
John P. KanskyVice President – Strategy and PlanningIndiana Health Information Exchange
Copyright © 2011 Indiana Health Information Exchange, Inc