A recent study by ICD MarketScape evaluated 16 vendors and concluded the HIE landscape is shifting from "connecting the ecosystem with exchange data and meaningful incentives," to transforming data into "actionable information."

"HIEs hold a unique position in the evolving HIT ecosystem to support the shift to actionable data," said John Stanley, principal with Impact Advisors. "[The] integration of independent but cooperative organizations and information systems place [HIEs] in the position to be mutual gateways for data management and workflow integration among participating organizations."



Stanely outlined five keys to HIEs in this changing market.

1. Their role is best known as the "central data collector." Initially, said Stanely, HIEs were focused on the basic data collection, aggregation and access to "cross-system data," mainly for basic patient care and cost savings. As a central data collector, they allow for "a single point of aggregation to support the population health management of patients," he said, which is "seen across this independent but cooperative continuum."

[See also: HIE as a verb: ONC wants to move quickly on data exchange.]

2. The evolution of the value of data called for better standards. As the value of aggregated data increased beyond simple point-of-care access and health reporting, and toward quality and performance management, the need for better data standards was clear, said Stanely. He added that whether or not this aggregation is physician or virtual, the centralized services of an HIE allow for the "normalization" of data standards across connected care settings.

3. HIEs hold tremendous value as a data routing service. Stanely said with the growing emphasis placed on protocols and measures of quality, performance, and costs, the market continues to embrace "best-of-breed solutions" for retrospective analytics, POC decision support, and care management. "As a common data routing or exchange service, HIEs are well positioned to support directing this data to appropriate community or enterprise tools, which can be utilized consistently and collectively by the connected care participants," he said.

[See also: HIE market still a little like the 'Wild West'.]

4. The connectivity layer inherent to HIEs holds incredible benefits. According to Stanely, this connectivity layer allows for the outcomes and outputs of analytics or decision support tools to be integrated into the workflow of connected solutions or user populations. "This can be implemented in collaboration with existing EHRs, or separately depending on the connected care participants, or the desired workflow," he said. "This component is new in the market and could represent the key to real change." He added this could impact both clinical effectiveness and costs, by offering a way to integrate multi-entity population "health evidence" into the real-time workflow of participating care settings.

5. The bar is being raised for vendors as the market continues to evolve. As the HIE market matures, and vendors realize the value and strength in this model, the bar is being raised for them to differentiate both themselves and their solutions, "in the context of actionable data for quality improvement or cost reduction," said Stanely. "Either through direct acquisition or by partnerships, the demand for buyer-efficient integrated or coordinated solutions – including both the connectivity services of HIEs and the analytics support of BI tools – are gaining momentum in the market."