Barriers Impede Health Data Flow

Health information exchanges represent a "megachange challenge" that won't be surmounted without breaking down financing, governance and policy barriers, the Washington-based Brookings Institution writes in a new report.

Health information exchanges are intended to allow doctors, hospitals and insurers to share information seamlessly and make health care more cost-effective and efficient. They also will retain insurance information for patients without coverage.

The good news is that HIEs have "made progress in establishing organizational frameworks, building technology-based connections, and bringing relevant groups to the table for discussion," co-authors Allan Friedman and Darrell West write in the introduction to the think tank's Feb. 8 report, "Health Information Exchanges and Megachange."

It's been more difficult for states and regions to agree on how HIEs should operate and how to fund them, the authors say. It's not even clear whether states ought to be operating exchanges because they don't take advantage of regional "natural marketplaces."

"Until those problems are overcome," Friedman and West write, "it will be impossible for HIEs to achieve their full potential."

If HIEs are to work, the authors say, "policymakers must present a clear vision, achieve consensus on key objectives, overcome organizational and market fragmentation, and work effectively with a range of different constituencies." Public and private leaders will need incentives to cooperate "in relationships based on mutual trust," they write, and sustainable business models and financing sources must be developed for the exchanges.