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Focusing on sustainability Once grant funding runs out, HIEs will need to be economically viable to sur- vive. Mr. Gilman says July reports from the HIEs to THSA and HHSC show HIEs are evaluating and fine-tuning their sus- tainability plans.
“Most HIEs determined their sustain- ability partners in the last year, and all HIEs have reported progress toward de- veloping a viable business model. HIEs are reaching out to a variety of partners including health professionals, physi- cians, businesses, pharmacies, nursing homes, federally qualified health centers, county health departments, and labs,” Mr. Gilman said.
Many HIEs’ sustainability plans in- clude fees for HIE services as a means of staying in business, he says. “The costs vary by HIE and differ based on the HIE model being developed and services offered,” Mr. Gilman said, adding that while HIEs consider physi- cians significant sustainability partners, they’re not charging them or are setting low fees to encourage participation. TMA policy says “any costs of sup- porting systems providing health infor- mation technology incentives to physi- cians should be borne by all stakehold- ers, clearly defined, fair, simple to under- stand, accountable, and should support the financial viability of the considered practice.” Dr. Langabeer says sustainability is a
top priority for Greater Houston Health- connect, and the HIE plans to require participants to pay an annual fee for ser- vices. He says physicians will pay $500 per physician per year. “We set a five-year plan back in 2012. By year five, we want to have 60 percent of all hospitals connected, and we want 50 percent of the 14,000 physicians in the area to use the system on a daily ba- sis. If we can achieve that level of con- nectivity, we estimate we’ll eliminate 1,350 adverse drug events and 2,400 preventable hospital readmissions every year,” Dr. Langabeer said. Greater Houston Healthconnect will
ultimately make medication histories available through the community health record and will develop a patient portal this year.
42 TEXAS MEDICINE February 2014
“The patient portal will be tremen-
dously valuable to patients. They’ll be able to access their medical records on any computer, even when they’re travel- ing,” Dr. Hoxhaj said. Dr. Fleeger says HIEs are “well on
their way” to providing physicians with accurate and timely patient information so a correct diagnosis and treatment plan can occur efficiently while ensur- ing patient privacy. He encourages physi- cians to get involved in their local HIE. “Although our HIEs have a way to go before they provide seamless health information on every patient in Texas, you’ll be surprised at how far they have come and how much information they can provide you,” he said. Participating in an HIE also assists physicians in meeting Stage 2 meaning- ful use measures that require hospitals and physicians to exchange information with outside organizations using differ- ent EHR systems. For more information, access the Stage 2 Eligible Professional Mean- ingful Use Core and Menu Mea- sures Table of Contents online, www
.cms.gov/Regulations-and-Guidance/ Legislation/EHRIncentivePrograms/ Downloads/Stage2_MeaningfulUseSpec Sheet_TableContents_EPs.pdf. Additionally, TMA’s EHR Implemen- tation Guide, EHR Product Compari- son Tool (TMA member login required), Medicare and Medicaid EHR Incentive Comparison, EHR Incentive Program Eligibility Tool, and Medicare and Med- icaid incentive program instructions are available at
www.texmed.org/hit.
Addressing challenges, concerns Ensuring access to an HIE for physicians living in Texas’ white space, the areas of Texas without local and regional HIE ac- tivity, is a priority for THSA. In the past, qualified health information service pro- viders (HISPs) supported white space HIE connectivity through Direct Secure Messaging, a method of exchange that functions much like email with addition- al layers of security. Direct messaging re- quires physicians simply to have Internet access; they don’t have to purchase new hardware or sign a long-term contract. The email messages and attachments
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