The Medical Society of Northern Virginia has announced the launch of HeaLixVA, a local, physician-led health information exchange intended to smash the data silos that continue to make providing primary care a difficult and isolated proposition. Leaders of the new HIE hope to avoid the political wrangling and competition that has stymied growth of other regional efforts by putting physicians, not hospital systems or payers, in charge of the task.
“Like a shared electrical system, a shared Internet system, we all benefit from a shared health information exchange. Anything else is parochial,” said Dr. Marshall Ruffin, Chief Technology Officer for Inova Health System and Vice Chairman of the state designated ConnectVirginia HIE, which has not yet made sufficient progress into the northern reaches of the state.
Despite being involved in multiple HIE projects, Ruffin believes that a multitude of small, competing HIEs can actually damage a region’s efforts to connect providers in a seamless way by preventing any one network from grabbing the lion’s share of participants and connecting them all at once. “Think of all the economic benefits of having standardized record sharing statewide. What’s so frustrating is we could standardize a health information exchange, but there’s a bunch of political interests that get in the way,” he said.
“The goal is to get as many people who can generate data as possible,” added Dr. Jim Jenkins, the medical director for the Fairfax Family Practice Centers, which will connect to Loudoun Medical Group and several laboratory systems in the initial phase of the project. “From the patient’s point of view, it reduces that feeling that no one knows what’s going on.”
Political wrangling and fierce hospital competition has been a significant challenge for states that have not yet achieved widespread HIE. Patient data is an important business asset for any healthcare organization, and the business case for allowing other providers to access that data to make treatment decisions or perform clinical analytics is not yet clear to everyone, especially providers who are still entrenched in fee-for-service reimbursements, where making it easier for a patient to visit another providers means a reduction of profits.
“We believe [patients] want their data, but the demand just isn’t there. Patients aren’t going to pay for it, and they’re not going to leave a practice unless they add that capability,” Shahid Shah explained to EHRintelligence. “So we have a general sense that it’s a good thing to have health information exchanges, but there’s very little long-term sustainable business profitability behind it.”
As providers shift to pay-for-performance reimbursement, where community-based population health management makes the case for cooperation between regional providers, the smaller local HIEs and larger statewide or multi-state organizations, will find an incentive for providers to join and flourish.
“We are finding that our move from fee-for-service to more value-driven care where now the participants all connected up will create a scenario where the participants are saving more money by being in a value added network,” Shah continued. “In this new value-driven world we’re going to see that these HIEs will make some headway. Not because it’s going to be good for the patient, per se, but because it’s going to be good for the providers.”