HIE 3.0: A Turning Point for HIE Business Models

December 7, 2022

Article Summary

HIEs juggle many priorities to improve their technology platform for better data quality. When HIEs support a broader audience and address gaps in clinical pathways, they can become the preferred access point for population health analytics, quality measure reporting, and health equity strategies.

health information exchange and health equity

Health Information Exchanges (HIEs) are in a transition period, ushered in by the pandemic and global spotlight on healthcare equity. HIEs will redefine their value for sustainability if they can quickly pivot technical operations to support innovative growth models and strategic partnerships. Health Catalyst recently introduced HIE 3.0, an outline of strategies to overcome revenue shortages, secure new partnerships, and meet federal guidelines for data exchange standards.   

Market Demands on HIEs

Aligning HIEs and other networks for nationwide interoperability is a major initiative through the Office of the National Coordinator for Health Information Technology (ONC). New regulatory models are quickly gaining industry support, such as the Trusted Exchange Framework and Common Agreement (TEFCA). TEFCA also supports equitable healthcare by connecting rural and suburban clinical networks so providers have access to connected data for high- quality care to patients in rural communities.   

HIEs can leverage cross-community data initiatives like TEFCA to drive planning and participation efforts for providers who are challenged with data gaps in a patient’s care journey. Having a scalable infrastructure will put HIEs ahead of the curve to participate in federal interoperability and other data- sharing programs that emphasize data quality.  

Data Quality Creates a Competitive Advantage

An innovative data foundation will help HIEs capitalize on revenue opportunities based on the quality and accessibility of their data. Health plans, for example, want data that has been validated by NCQA for reporting on Healthcare Effectiveness Data and Information Set (HEDIS®) and other quality measures. HIEs that validate their data streams through NCQA Data Aggregator Validation (DAV) certification can reduce the workload for health plan staff who might be assigned manual primary source verification tasks.   

WISHIN was among the first HIEs to earn NCQA DAV status. Their health plan participants anticipate that leveraging the validated, automated data will lead to a greater than 10% increase in performance measures, including blood pressure and hemoglobin A1c control. Becoming NCQA DAV certified, or aligning with a Certified Data Partner, expands HIE revenue opportunities.  

In addition to the NCQA DAV program, HIEs should seize opportunities to modernize their exchange platforms to meet the newly released United States Core Data for Interoperability Version 3 (USCDIv3) and other federal standards. HIE platforms’ ability to keep up with industry standards is key in creating a more sophisticated interoperable system that establishes a competitive advantage.  

Leveraging a technology partner with vast experience in meeting  data quality standards and co-creating modern HIE solutions offers value-add services to the market and expedites the transition to HIE 3.0.  

Action Plan for HIE 3.0 Success

HIEs are juggling many priorities to improve their platform for data tracking, analytics, and data quality improvements. The effort to support a broader audience and address gaps in clinical pathways is worthwhile and will position HIEs to become the preferred data access partner for population health analytics, quality measures reporting, and health equity initiatives.

Download our new white paper, HIE 3.0: Sustainability through Strategic Partnerships and Scalable Technology, for a deeper look into HIE use cases and recent successes in technology innovation. https://go.healthcatalyst.com/WS-221109-HIEAwarenessPage_LPv2.html  

Additional Reading 

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