Health information exchanges (HIEs) have had a mixed record of success. This type of organization can be defined in the following way, courtesy of Wikepedia:
Health information exchange (HIE) is defined as the mobilization of healthcare information electronically across organizations within a region, community or hospital system. HIE provides the capability to electronically move clinical information among disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, equitable, patient-centered care.
The key to success of HIEs is sustainability, both financial and organizational. Here's a key quote relating to HIE failure from the HIELIX web site:
Sustainability is the issue that most frequently causes HIE failure. With so many stakeholder groups, finding financial success through the implementation of new software, new computer systems, new training and new business models can seem impossible. Success comes from building consensus between these stakeholders and creating a plan that realizes significant cost-savings by improving operational efficiencies and building scalable solutions.
I was unaware until I read Mr. HIStalk's recent note that Epic was in the HIE business (see: Monday Morning Update 1/2/12). I now know otherwise. Here it is in its entirety:
Cleveland, OH health systems Cleveland Clinic and MetroHealth are sharing electronic patient records and Kaiser Permanente will join them shortly. They’re using Epic’s Care Everywhere rather than an HIE, meaning they can access the records of patients who have opted in from 300 hospitals and 4,000 clinics.
Here's a description of Care Everywhere from the Epic web site (see: Epic Interoperability):
Care Everywhere provides a framework for interoperability, so that wherever the patient goes – between healthcare systems in the same town or across state and national borders – the clinicians providing care can have the information they need. Information can come from another Epic system, a non-Epic EMR that complies with industry standards, or directly from the patient. When an Epic system is on both sides of the exchange, a richer data set is exchanged and additional connectivity options, such as cross-organization referral management, are available. Regardless of the information source, Care Everywhere connects it to your EpicCare EMR, giving clinicians a more complete clinical record
Care Everywhere strikes me as a logical and tactically admirable addition to the broad Epic software suite, taking advantage of the company's now dominant presence in the large hospitals (see: Does Epic Exercise a Near-Monoply for EMRs in Larger U.S. Hospitals?; The Feasibility of Using the Epic EMR as a "Platform" to Extend Its Functionality). Moreover, it's also an effective response to critics of the company who say that it's not interested in interoperability (see: Judith Faulkner, EMR Interoperability, and Washington IT Politics). The charge seems to be false, at least when its own client hospitals are involved.