HIE UPDATE
Q&A: SHIEC’s Lisa Bari on ‘Critical Time for HIEs in This Country’
By David Raths T
he nonprofit Strategic Health I n fo rma t i o n E x c h a n ge Collaborative (SHIEC) represents
81 health information exchanges (HIEs) and their strategic business and tech- nology partners. On Oct. 9, SHIEC’s board announced the appointment of Lisa Bari as interim CEO, succeeding Kelly Hoover Thompson. Bari, who previously served as the
health IT and interoperability lead at the Centers for Medicare & Medicaid Services’ Innovation Center, took time on Oct. 22 to do a Zoom interview with Healthcare Innovation about her goals in the new position and the critical role of HIEs during the pandemic.
Because your appointment is interim, do you have to have more of a short-term focus or are you working from a strategic plan
already in place? Bari: We are definitely having those conversations with the board. The role of an interim CEO can be many differ- ent things. Generally people are of the opinion that it is a really critical time for HIEs in this country and for the healthcare system and public health overall. HIEs play a really big role in that, so there is no way we can sit back and not make decisions and plans right now because everything is happening at the same time. For instance, the CDC just released interim guidance on how they are planning on doing immuniza- tion tracking. We have to act now.
You spent several years working on interoperability issues at the CMS Innovation Center. Are there some things you learned from that experience that you can read-
ily apply to this new position? Bari: At the CMS Innovation Center I worked with HIEs as well. I designed health IT and interoperability policies for the Comprehensive Primary Care Plus model, which at the time was the largest test of primary care pay- ment and delivery system innovation in the world. We intentionally wrote in policies to encourage primary care practices to use their regional HIEs. So I have been doing this work since then. I really believe in the value of health
information exchange as a key under- pinning and enabler of value-based care, which is what the Innovation Center is about.
One of the initiatives SHIEC is best known for is the Patient Centered Data Home [PCDH]. Is that something that you want to
expand upon? Bari: The Patient Centered Data Home is a project SHIEC members are focus- ing on. We are figuring out how it will fit in the overall landscape. There are a lot of opportunities right now around creating national connectivity and tak- ing advantage of the CMS interoper- ability and patient access rule and the ADT notification requirements that are coming into effect really, really soon. They were extended until May 2021. We believe PCDH will likely play a role in the implementation of some of those new requirements as organizations look at how they comply with these new rules.
Do you have some strong feel- ings about the approach the RCE is taking with TEFCA? Do the SHIEC members have a clear idea of what their role is envisioned to be in that framework as the
QHINs are defi ned? Bari: We don’t have a strong perspective on what the RCE is doing, specifically. Certainly, different SHIEC members are going to become QHINs or not. They are looking at that right now. I think with TEFCA, I am just really concerned because of the approach CMS took in the final rule of not including TEFCA in a meaningful way. They didn’t give it the importance or support or didn’t make it required.
It’s like they were on separate
tracks. Bari: Exactly. That is really concerning. Fundamentally, if you ook at the idea and conception of TEFCA, that makes sense, right? We need a model agree- ment. We need standard rules of the road. So SHIEC may get more involved in that and the RCE may get more involved in that, but until it is writ- ten into requirements and given some
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Lisa Bari
teeth, it is going to be a little tough to see it moving forward quickly.
Are HIEs starting to understand that creating a repository of regional data for lookup may be- come commoditized and may not be a viable business model going
forward? Bari: One thing you can say about HIEs is that they all have different perspec- tives. I would say it is tempting for everybody to look at the environment and say a single tech vendor can do that. But that doesn’t work because the healthcare landscape is intensely local and political. State laws are criti- cal for data sharing. HIEs generally are nonprofit, vendor-neutral and highly tied into their states and communities’ systems of governance. You need those HIEs connected to their communities to make health data sharing happen. That is how I see it.
But do most HIEs see that they have to provide more value-added services such as aggregating data for analytics and clinical quality measures, including merging clinical and claims data? Doing ADT feeds? Or building connections to post-acute care and behavioral
health? Bari: Absolutely. Just doing basic pro- vider-to-provider health record sharing is absolutely not cutting it. HIEs are
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