Five Trends Shaping Health Information Exchanges in 2021
With healthcare transitioning from fee-for-service to value-based care, the role of health information exchanges (HIEs) – including how they support providers and payors – is changing. Below, we dive into several trends shaping today’s HIEs.
- Aligning with higher standards – Today’s HIEs are aligning with the initiatives rolled out by Centers for Medicare & Medicaid Services (CMS), Office of the National Coordinator for Health Information Technology (ONC) and National Committee for Quality Assurance (NCQA). For example, when it comes to the new rules posted by CMS interoperability and patient access, especially those around admission, discharge and transfer (ADT) notifications as well as payer-to-payer data exchange, HIEs are well positioned to reduce the burden on their member organizations.
- Addressing the needs of key stakeholders and value-based programs – We are seeing an increasing dependency on HIEs across the country to support the data and analytics needs of several value-based programs. For example, many organizations participating in bundled payment programs are seeking ADT information for post-acute care activity. This level of data is typically provided by HIEs, making them especially valuable for stakeholders.
- Moving beyond clinical data – Traditionally, HIEs have focused on providing clinical data. Now, an increasing number of HIEs include data around claims, Prescription Drug Monitoring Programs (PDMPs), Social Determinants of Health (SDOH) and public data sets. Combining this data at the patient level is valuable for member organizations, who can then leverage the information to make more informed decisions.
- Shifting from data pull to data push – Generally, member organizations simply logged into their systems and “pulled” or extracted the data they needed to care for their patients. Now, HIEs can actually “push” or provide information to member organizations so they can consume the data within enterprise-wide warehouses.
- Renewing focus on public health – The evolving COVID-19 pandemic has placed greater emphasis on the relationships between HIEs and public health initiatives. There are numerous stories where HIEs have played a key role in supporting public health needs. We anticipate that this trend will extend to other disease surveillance opportunities and ultimately build an infrastructure that is more proactive in nature.
As with anything in healthcare, the role of HIEs is constantly evolving. With the continued shift from volume-based to value-based care, HIEs have been at the center of the change, supporting healthcare organizations around several use cases well aligned with the initiatives proposed by the CMS, ONC and NCQA. With a clear understanding of these changes, you’ll be better equipped to position your organization as a leader in providing value-based care.
What trends have you observed with HIEs recently? Comment below to share your thoughts.
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The Indispensable Value of Health Information Exchanges
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