HIEs and Information Sharing: Physicians Feel the Pressure

The exchange of clinical data is one of the three pillars of the EHR incentives program, and the legislation was intended to serve as a stimulus (pun intended!) for the creation of health information exchanges (HIEs) by including significant funding earmarked for their establishment. The stage 1 meaningful use requirements provide further support by requiring physicians to take a first step towards information sharing. EHR adoption was expected to be the impetus for the development and flourishing of HIEs.

HIE and Information Sharing - Physicians Feel the Pressure

It appears that it may be just the opposite—interest in HIEs may be driving adoption of EHRs, rather than the other way around. Growth in the HIE arena is coming from private HIEs—those sponsored by health care systems to connect their own providers and facilitate the effective sharing of clinical information about their mutual patients. The growth in private HIEs is far outstripping the growth in community HIEs, according to KLAS, and physicians are facing new and stepped-up pressures to participate.

It is no longer just the carrot of the meaningful use incentives at play. The following are just two examples that have recently been brought to my attention where sticks are being used to “encourage” physician participation in information sharing. The University Physicians Network (UPN) at NYU is making participation in its information-sharing network a requirement for membership in the UPN, without which physicians do not have access to the group’s favorably negotiated reimbursement rates. A similar physician group in Massachusetts is making membership in its network a prerequisite for patient referrals.

I’m interested in hearing from readers about the development of HIEs and other information-sharing networks in your markets, and the carrots and/or sticks associated with participation.

7 thoughts on “HIEs and Information Sharing: Physicians Feel the Pressure

  1. The original shining purpose for HIE’s was a public one–now it is becoming a virtual private network.
    Hopefully the collaborative spirit will win out over the capitalist self interest, but my overriding hope is that perhaps both types of HIE will thrive alongside one another.
    One vision is to provide an incentive for participation in an HIE by offering “The Monorail”, which would simply be a VPN cross connect to a 10G network with superior bandwidth speeds(10 times a gigabit Ethernet connection). The real carrot could be the establishment of this 10G network whereby hospitals could securely transmit their PMI/HIE data and other electronic imaging, archival, DR, and electronic commerce data as well. It would be a heavy capital outlay on the outset, but I think subscriptions could/would sell like hotcakes.

  2. Our Hospital system offered to pay for a portion of the costs of installing their HIS. Fortunately, negative feedback from specialty groups forced them to allow other systems chosen by individual practitioner groups.
    Our Hospital system is now setting up it’s own Medicare advantage insurance offering payments to MDs below Medicare rates. My fear is that refusal to accept these rates would result in an elimination from the hospital referral network.

  3. In your “EMR Straight Talk of August 10, 2011, you write of the requirement that University Physicians Network has imposed as a condition of membership in UPN to have an EHR linked to NYU’s related Health Information Exchange. You state that without UPN membership “ physicians do not have access to the group’s favorably negotiated reimbursement rates.”

    While I can understand that you are not familiar with UPN, I must advise, and insist that you correct your representation that this group has “favorably negotiated reimbursement rates”.

    UPN does not now, nor has it ever engaged in negotiation with any payer or health plan outside of fully compliant shared risk arrangements. Your representation is factually incorrect.

    In reality it is collaboration and cooperation with payers that accrues benefits to the UPN membership. The requirement as to physician information technology is part of a broad initiative to promote enhanced quality and the delivery of more efficient health care.

  4. I’ve seen this happening in my area. The privately based HIEs are seemingly moving at a much faster pace than the one being sponsored by the regional REC.

  5. I really don’t like the idea of doctors being required to share my private healthcare information with other doctors. My private health information is mine, my doctor’s, and my family’s business alone, no one elses.

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