Health information exchange is playing an important role in the healthcare system by improving interoperability, especially as technology is evolving constantly and options for exchanging health information are increasing. With providers realizing the benefits of HIE in patient care, it is increasing across countries.
Technological advancements in the healthcare industry continue to provide new ways to improve the quality of care delivered to the patients, while advancing the state of the global digital healthcare system. Information technology has significantly contributed to the healthcare industry with the increasing use of telehealth services, electronic medical records, and mobile technologies. Additionally, the demand for electronic health information exchange (HIE) is surging among healthcare professionals owing to the increasing demand for an efficient healthcare system.
HIE is the electronic transformation of healthcare-related data among medical facilities, health information organizations, and the companies that require and govern the exchange of this data. Electronic HIE allows healthcare professionals like doctors, nurses, pharmacists, and patients to suitably access and securely share a patient’s vital medical information electronically, thus improving the speed, quality, safety, and cost of patient care. While HIE typically refers to the act of exchanging information between two or more healthcare organizations or providers, it may also refer to an organization that is responsible for facilitating the exchange. The purpose of HIE is to promote the appropriate and secure access and retrieval of a patient’s information to improve the cost, quality, safety, and speed of patient care.
Services of the HIE market intend to help its providers to reduce medication and medical errors, eliminate unnecessary paper work, provide caregivers with clinical decision support tools for more effective treatment, improve public health monitoring and reporting, improve healthcare quality, and reduce healthcare costs.
Global market
The global HIE market was valued at USD 1347 million in 2019, and is expected to reach USD 2552.9 million by 2026, at a CAGR of 9.4 percent, estimates Reports and Data. The significant factor contributing to the growth of the HIE market is increasing awareness among people about the advanced technologies to exchange information related to health and growing applications of EHR devices. Expansion in the global HIE market is primarily driven by federal mandates like meaningful use, increasing patient-centric approach in healthcare delivery, rising EHR acceptance rate, and must to curtail healthcare costs.
The HIE market is likely to expand over the next 6 years with significant opportunities like increasing demand for PHR and EHR in economically developing nations. Increasing the adoption of mobile health applications and cloud-based systems is likely to provide lucrative growth opportunities in coming years.
The necessity of significant infrastructural investments, with low return on investment and data security and privacy concerns, are primarily restricting the growth of the HIE market. Further, the budget restrictions in developing countries, high costs associated with high-end technologies, and interoperability issues.
The internal interfacing segment is the fastest-growing segment with a CAGR of 10.1 percent in the HIE market during 2020–2026. Internal interfacing is presumed to propel the demand for HIE.
In 2019, the direct exchange segment had the most substantial share market value, based on type. The growing trend of passing the documents to the physicians and point-to-point transactions support are the key factors helping this segment to continue the lead.
Among all, the hybrid model segment is likely to account for the largest share in the coming years. Increasing changes in delivering patient care, and also in improving the quality of operational efficiency are critical attributes for this segment in the market to grow eventually.
The private HIE segment is likely to dominate the market growth owing to the existence of a vast number of service providers and increasing need for quality treatment services, which are accelerating the demand of HIE, based on setup type. Also, growing interest to decrease the cost and offer better services to the patients in both private and public organizations are leveling up the growth rate of the market.
The internal interfacing segment leads the market growth due to the increasing number of patients, who are associates through the use of engagement tools in healthcare centers, based on application.
Based on the component, the RLS and clinical data repository segment held the largest market share in 2019. Increasing awareness over the availability of various techniques in healthcare centers is propelling the growth of these segments.
North America is contributing a significant share in global HIE market owing to the increasing adoption of EHR, favorable reimbursement policies, and the presence of substantial stakeholders of the worldwide HIE market.
Asia-Pacific is expected to grow rapidly at a CAGR of over 10.6 percent with the rising disposable income levels and the increased awareness levels amongst healthcare practitioners regarding the HIE systems. High growth in this regional segment can primarily be attributed to the growing initiatives for Japan’s EHR adoption and ICT fund, investments and reforms to modernize China’s healthcare infrastructure, rapidly growing Indian healthcare industry, implementation of HCIT programs in Australia and New Zealand, and One Singaporean One Health Record – one of the pioneer patient management programs in Singapore.
The industry is highly competitive in nature and the players are involved in sustainability strategies such as new product launches, strategic collaborations, mergers and acquisitions, and technological innovation. For instance, Cerner Corporation has completed the acquisition of AbleVets in 2019 to achieve higher technical expertise and scale in the design and implementation of solutions.
The major players in the market are GE Healthcare, IBM Corporation, Siemens AG, Orion Health, Allscripts Healthcare Solutions, Inc., Cerner Corporation, Covisint Corporation (Open Text Corporation), Epic Corporation Inc., Infor, Inc., Medicity, Inc., NextGen Healthcare Information Systems, LLC, Optum, Inc., and Orion Healthcare.
Opportunities Health information exchange is playing an important role in the healthcare system by improving interoperability, especially as technology is evolving constantly and options for exchanging health information are increasing. With providers realizing the benefits of HIE in patient care, its use is increasing across countries. Here are a few benefits of HIE.
Care coordination. This is a dynamic process that requires data movement across platforms and among service providers in real time. Many EHR systems, in spite of being developed by the same company, do not talk to each other, creating delays and decreasing the value of the system.
Record locator services/master patient indexes. Enable creation of one continuous community record, facilitating patient identification across multiple provider settings.
Data exchange. HIEs/HIOs provide support for vocabulary and code sets, including content mapping, and enable data transactions to occur automatically across multiple providers and settings.
Data aggregation and analysis. This includes clinical data aggregation across HIE partners, as well as data analytics and warehousing.
Performance outcome management. Population-level data analysis is an essential component of pay-for-performance programs, ACOs, public health systems, and other stakeholders.
Business intelligence analytics. Enable better risk analysis and better, more cost-effective care of high-risk patients.
Clinical messaging. Standard HIE services often include laboratory results, emergency room notes, medication lists, discharge summaries, progress notes, radiology results, and surgical notes.
Support for EHR, PHR, and MU adoption consultation. HIEs and HIOs facilitate the preparation of scorecards for services using claims and EHR data, and support achievement of meaningful use (MU) requirements.
Patient consent. Where consent is not governed by other laws or regulations, an HIE-based centralized consent management process can enable consensus among the community’s stakeholders for a patient consent model.
Connectivity. HIEs/HIOs provide connectivity choices such as Direct, the eHealth Exchange, and other connectivity services.
New care delivery methods. HIEs/HIOs can be essential components in both the development and operation of ACOs and patient-centered medical homes.
Data sharing. Consolidation and reduction of data interface costs by data sharing for patient demographics, electronic medical record (EMR) data feeds, laboratory data, radiology data, and scanned paper documents.
Cost reduction. An effective HIE system can reduce health-related costs as it provides information and patient data digitally. Moreover, it also provides personal health information to healthcare consumers.
Acts as a support tool. HIE system acts as a support tool for doctors and healthcare providers, offering clinical decision support for better treatment and effective care.
More opportunities. Access to robust HIE can open up future opportunities such as care management platforms, cross-facility utilization, and advanced clinical and financial analytics. The HIE system is also helping governments across countries by providing access to public health data in a timely manner, and helping governments to plan and prioritize programs to improve the health of people.
Challenges Ensuring data privacy and security during the process of data exchange is vital. Hence, organizations need to follow federal and state regulations to provide data security, while allowing free flow of data that is necessary for patient care and treatment. The most important obstacle facing HIE depends on the perspective of who is looking at it – the provider or the patient.
Some of the common challenges associated with HIE include:
Insufficiency in standards. Lack of standards in digital health information exchange can lead to some privacy concerns. Hence, information exchanged digitally must adhere to some standards in order to be used in EHRs.
Lack of clarity on requirements and variations in rules. Exchanging health information in other states can be difficult owing to the variation in privacy rules. Moreover, providers are finding it difficult to comply with the state laws when exchanging patient’s health information with the provider in other states.
Difficult to match patients to their health records. It is difficult to match patients to their health records when exchanging health information. Providers are finding it difficult to match patients with the health records and exchange information, owing to the presence of several patients with the same name, birth year, and living in the same area. Hence, there is a need for an identifier that can match patients with their health records.
Cost of HIE. Covering the cost of HIE can be difficult as it includes various costs such as purchasing and implementation cost, cost to participate in local or state HIE organization, and transaction fees for exchanging information by vendors. Moreover, sometimes additional cost comes up including establishing an interface for health information exchange.
Contains only summary document. Some HIEs only contain a summary document that can also be referred to as continuity of care document. Owing to the generic nature of the document, it sometimes misses important information on the patient’s health that may be important to provide the correct treatment.
Patient consent. Authorization by the patient is one of the biggest challenges in HIE, as authorization is important to exchange health data through various technology and healthcare platforms. It may also lead to legal risks if the health information of the patient is shared without the patient’s authorization.
Rising competition. Competition among HIE providers is intense. Organizations are likely to continue to compete for the patient, and on sharing information. According to the report from Harvard Business School, sharing health information is the biggest concern among healthcare providers, and it is such that it impedes HIE development.
Outlook In a nutshell, modern healthcare is being driven by information; documents are stored in EHR systems and organized for exchange. With several healthcare organizations paying attention to the benefits of HIE, it is increasingly becoming the cornerstone of efficient clinical workflows and patient outcomes. Even though some challenges persist, the exciting new developments and opportunities promise a bright future.
