Tuesday, March 13, 2012

At Long Last ! Inland Empire HIE to go Live April 1 2012



Gary M. Levin M.D.

I feel like the great grandfather who set something in motion that might have occurred anyway.  I do have the satisfaction of knowing I was right all along back in 2002 when I am sure I was hailed as the “Don Quixote’ of the Inland Empire. There were few then that could appreciate the vision of what we see unfolding.

All I can add is a profound  “Thank you   to those who took up the  baton when I laid it down, as I weathered several serious illnesses. There are now many community physicians, paid consultants, and champions of the movement. My dream and ambition would not have occurred except for them.

Ten years passed. And today I read some good news.

“  One of those exchanges is Inland Empire Health Information Exchange (IEHIE), which is made up of 48 providers in Riverside and San Bernardino counties, and is scheduled to become operational April 1.

At a time when the value and sustainability of public health information exchanges (HIEs) are being questioned, Inland Empire Health Information Exchange (IEHIE), which plans to go live on April 1, is making a case for both.

IEHIE, comprising 48 healthcare organizations in Riverside and San Bernardino counties including hospitals, physicians and payers, boasts an operational self-funded business model and a collaborative spirit. These two critical components make IEHIE unique, according to Executive Director Richard Swafford.

There is no public funding or state grants for IHIE. Any public funding comes from county stakeholders, a large managed care medi-cal organization (IEHP) which serves 600,000 participants and multiple hospital and physician group stakeholders.    From day one IHIE was drawn up and implemented by the stakeholders without public involvement and it will be sustainable. 

The collaborative spirit carried over to the business model. All stakeholders agreed to pay for value-added services via a fee structure determined by participant type – payers by number of lives, medical groups per physician and hospitals by bed size. IEHIE was formed as a 501(c)3 organization, with the goal of breaking even, not making a profit, Swafford explained. Although the HIE infrastructure contract with Orion Health, whose Orion Health HIE platform is powering the exchange, was completed some six months ago, it wasn’t signed until the current 14 pilot participants paid their fees in advance. “We aren’t relying on grants as a mechanism for sustainability,” he emphasized.

Sustainability has always been the glass barrier for RHIOs and now HIEs. Some of the most successful HIEs failed shortly after the startup grant money was gone. (Santa Barbara Exchange, started by David Brailer MD, the first head of ONCHIT.)

IEHIE’s strategy is also to be the utility for entities that want to leverage other programs and capabilities. The accountable care organization (ACO) model, for example, requires the ability to share patient information in order to effectively participate in an ACO environment. “We rely on our participants to tell us what their requirements are so we can integrate them into our overall strategy,” Swafford said.

When the community-based HIE goes live April 1st, Gagnon predicted, “We’re going to knock everybody’s socks off.”

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