Health information exchange (HIEs) have been struggling since their inception to stay afloat. At the regional or state level, they serve the function of integrating health information generated for patients across the various providers in an area. One of the major problems that bedevils them is developing a successful financial model. Although their mission is critical and despite the fact that vast amount of money are spent on healthcare in the U.S, clinical data integration is not a high priority for many hospitals. The Delaware HIE has come up with a new source of revenue (see: Delaware HIE Teaming Up with iSpecimen to Turn Remnant Clinical Pathology Laboratory Specimens into Cash). Below is an excerpt from an article on this topic:
The Delaware Health Information Network (DHIN) has entered into a novel collaboration that may help address the medical research community’s growing need for clinical specimens. At the same time, this agreement will also provide a much-needed new revenue stream for participating medical laboratories and hospitals. With Medicare and health insurers reducing reimbursements for laboratory tests, medical laboratories and pathology groups are facing uncertain financial times. However, DHIN’s new partnership with iSpecimen of Massachusetts highlights the potential value of remnant clinical specimens—samples that otherwise would be discarded once patient testing is complete....DHIN is the first data aggregator in the iSpecimen network, which today includes more than 50 hospitals and commercial lab, 400 clinics and practice groups, 10 biorepositories, and a large blood center. Delaware Health Information Network CEO Jan Lee, MD, believes her organization’s collaboration with iSpecimen not only will benefit the medical research community but also will reduce the fees paid to DHIN by member hospitals and medical laboratories that take part in the initiative....[She] believes her organization’s collaboration with iSpecimen not only will benefit the medical research community but also will reduce the fees paid to DHIN by member hospitals and medical laboratories that take part in the initiative....."We have data from every hospital and every commercial lab in Delaware. If they used our data source to identify the specimens of interest, they will get a higher hit rate.” ....DHIN will credit 75% of the transaction fees it receives from iSpecimen back to the hospital or laboratory that donated the clinical specimen. iSpecimen generates its revenue by charging participating researchers for the matching service. Patients must provide informed consent to have their specimens used in an active research project, a requirement that has muted enthusiasm for the joint venture among some DHIN members.
Remnant serum, blood, or tissue samples by themselves are almost worthless. However, linked to a patient's clinical history and deidentified, they becomes extremely valuable for researchers in general and certainly for support drug company researchers. As noted in the excerpt quotes above, two of the major limiting factors for the sale of remnant serum and tissue by hospitals has been (1) obtaining informed consent from the patients and (2) the possibility of pushback from patients concerning such sales even if the specimens are deidentified. It's possible that moving the sales process one step away from the hospitals to an organization like the Delaware Health Information Network/iSpecimen might cause less distress for patients. Moreover, I think that a convincing argument could be made by the hospitals to their patients that such sales help to support the non-profit DHIN and thus support patients by making their integrated health record readily available across multiple facilities.