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Archive for the ‘health portals’ Category

(Note: This is the second of a two-part post.)

Keeping it Local

This is most representative of the status quo and the most realistic path forward for the vast majority of payers who typically operate at the local level. In this scenario, one or more health plans in a regional market partner with other community stakeholders to co-fund and sustain a regional HIE. These stakeholders typically include large corporations with a large local employee base and/or provider organizations. Successful examples of such multi-stakeholder HIEs include the Louisville HIE (Humana, Anthem, Ford, Yum! and Kroger), and the Rochester RHIO, where payers (Aetna, BCBS, MVP) and hospitals share a 2/1 split of all operating expenses on a transaction model.

The benefit to payers in participating and most often funding the majority of such an HIE is three-fold. First, partnering with other organizations in the region contributes to a greater “fabric of trust” between the HIE and physicians within the region leading to greater physician participation. Secondly, by partnering with others, the payer is able to share HIE operating costs with other stakeholders. Third, physicians actively exchanging patient data can prevent some hospital readmissions and decrease duplicative lab and imaging tests, thereby lowering a payer’s total coverage cost in the region.

Conclusion: As HIE’s unfold at the community scale, local and regional stakeholders will share the operating costs and governance. As far as payer support for HIE’s goes, Chilmark predicts continued growth of these types of HIEs, particularly in less urban communities. We also predict that there will be significant growth in enterprise HIEs that are partially funded by payers, ultimately in support of a payer-provider partnership to establish an ACO. (Again, look to the recently announced NaviNet-Lumeris deal wherein three regional payers also played a role. For those payers, it’s all about making the provider transition to ACO/PCMH models as frictionless as possible.)

Real Challenges Remain

Despite a seemingly straightforward path for payers to get involved with HIE’s, there remain a number of challenges. These are two-fold in nature: Regulatory and Marketplace. On the regulatory front, the list of challenges is long and familiar: ICD-10 (while it seems like there will be another delay, much to the chagrin of the AMA this isn’t just going to go away) and HIPAA 5010, health insurance exchanges and other health reform mandates. (On the plus side, health information exchange-related spending counts favorably towards new medical loss ratio (MLR) rules).

However, the marketplace is where the true challenges lie, as there is hardly a guarantee that payers and provider groups will play nice with each other. Nowhere is this more evident than in the Western PA market, where a sort of fisticuffs have been going on between Highmark BCBS and UPMC.  Without going into the sordid details, Highmark (who just bought Pittsburgh’s second largest hospital network, West Penn Allegheny) and UPMC are now building competing HIEs in the same region because of a longstanding spat over contract negotiations. To hospitals who are now faced with participating in two separate HIE’s, this does not make much sense.

For the payers however, it does make sense when cast against the backdrop of rising competition. (Chilmark noted this challenge after attending the AHIP confab last summer.) Insurers are fighting with each other to keep their networks competitive. Providers are fighting with each other to secure preferred referral status, i.e. patient volume. Introducing an HIE in the middle of this environment has wide reaching implications for where patients are sent as well as who accrues and shares the savings. Throw in the variable of different reimbursement rates for commercial, Medicare and Medicare Advantage patients and you can see why partnering up to set up an information network is more than simply writing a check.

2012 and Beyond

So what does this all mean for a huge guest who’s seemingly unwanted at the party? Ultimately, payers’ involvement boils down into a few categories:

  • In the light of the tighter margins imposed by health reform, insurers who can afford it will diversify their business. The national health plans will be looking to acquire their own platform ala Aetna and UHG, with the additional hopes of squeezing cost savings out provider users and building a more favorable MLR. The main considerations in predicting this shift include vendor consolidation and the readiness of existing provider networks to collaborate.
  • Regional Insurers, such as the Blues and other statewide or multistate networks, have the wherewithal to setup and license their own platform for exchange either through payer-payer partnerships or on their own. The recent NaviNet deal seems to be more of an ACO play, but indicative of the business strategy of this class of payers who are willing and able to be flexible in how they approach their role as stakeholder in information networks.
  • Local Insurers who have fewer resources and who operate directly in the tides of market competition will opt for a ‘safer,’ multi-stakeholder approach in their communities. Partnerships will be heavily influenced by network dynamics, reimbursement channels and existing arrangements, such as burgeoning accountable care communities.

So, as rosy as information exchange seems on paper, it is permanently changing the way that provider and payer groups do business. From where Chilmark stands as an observer of the market’s evolution, it is all too clear that payers and providers ultimately have little choice but to work together. Payment reform and millions in IT incentives have already begun to influence the way that the delivery and payment markets work; the future of accountable care, proactive population health management and ‘smart’ health care delivery all depend on willing and trusting partnerships.

Unfortunately, as is too often the case, patients and other stakeholders get left out of the decision calculus. Pittsburgh residents will hardly benefit from the competitive business posturing there. We hope the folks deploying HIE’s over the coming years will put as much of an emphasis on leadership and governance as they do on technology and of course, the health of their business.

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It is almost becoming the norm to say that it has been another tumultuous year in the healthcare IT market. Market consolidation, pushback on timelines, growing chorus from IT departments that enough is enough against the backdrop of the political circus in Washington and across the land as we prepare for the 2012 election year. If 2011, was a bit bumpy, believe we will see craters in the road to HIT enlightenment in 2012. But we’ll save that discussion for our future predictions for 2012 post, which we hope to get to next week. (Editor’s Note: Don’t hold your breath though, if the snow flakes are flying, we’ll be on the slopes next week.)

Today’s post takes a look back on 2011 by reviewing our predictions earlier in the year and assessing where we hit the mark, where we missed and if there is such a thing, where we came close. So without further adieu…

1. MU Initiatives Move to Tactical 
Hit This did come true as meaningful use, while still top of mind for the CIO, is not top of mind for others in the executive suite who are now looking at how to compete in the future as reimbursement models shift from fee-for-service to value-based contracts.

2. C-Suite Strategy Focuses on New Payment Models 
Hit An admittedly “softball” prediction, this was a natural fall-out of prediction numero uno. And yes, the consultants are making out like bandits as we predicted they would helping senior execs figure out their future competitive strategy.

3. RCM & Charge Capture Systems Require Overhaul 
Miss By and large, most vendors in this sector have not done a whole lot yet as they await to see how the market develops. With most healthcare organizations struggling to get the basics done (e.g., meet MU requirements, ICD-9 -> ICD-10, apply analytics, etc.) we are not seeing big demand from customers and subsequently, not a big push by vendors.

4. Mergers & Acquisitions Continue Unabated
Hit Another “gimme” of sorts for we had this prediction in 2010 and it was a “hit” and need only look at this market with its some odd 300+ EHRs to choose from, everyone wanting to call themselves at HIE vendor (last we checked, HIMSS listed some 189 HIE vendors alone), countless other HIT solutions to see that this market is far from mature. But arguably the biggest news in 2011 was Microsoft’s capitulation that despite the billion dollar plus investment, it wasn’t cut out or the clinical market and dumping its HIT assets into a new joint venture with GE. What we are also seeing is some rationality return as valuations have moderated. This may have led to Thomson Reuters’ recent decision to not sell-off its healthcare division – no one was willing to pay the high price tag they had on this property.

5. Federally Funded State Initiatives Struggle
Toss-up There has been some progress and there are those that would vehemently argue that Beacon Communities, RECs and state HIEs are moving ahead briskly. But then again, we do get some disturbing reports that all is not progressing as once envisioned, one might even go so far as to say some of these programs are beyond just struggling, but clearly going off the tracks. We’ll reserve judgment until we see clear evidence of such pending disasters, which will likely be prevalent, but highly distributed.

6. Changing of the Guard at ONC
Hit Not long after we posted our 2011 predictions, Blumenthal announced his resignation from ONC. We could not have been more prophetic if we tried.

7. Physicians will continue to go Ga-Ga over the iPad and the fast-following touchscreen tablets much to the chagrin of CIOs.
Hit Enabling physicians access to health information systems via their hand-held mobile devices, including touch-screen tablets is still a struggle for most organizations. At first, IT departments turned to Citrix as stop-gap measure, but the UX was far from ideal. In our recent research we found many an IT department still struggling to address this issue. mobile enablement of physicians is a top priority.

8. Apps Proliferate: Consumer-facing First, Private Practice Second, Enterprises Dead Last
Hit In hindsight, another admittedly easy prediction to make. What may be a more interesting prediction is when will mHealth Apps really become a truly viable market? Does the profitable exit of iTriage/Healthagen, which was picked up by Aetna portend such? By our standards, no. Go back to our recent post from the mHealth Summit for more in-depth analysis.

9. The Poor Man’s (doctor’s) HIE Takes Hold
Miss We thought that the Direct Project would quickly take hold and see rapid adoption among smaller physician practices and those organizations looking to “connect the last mile” to small affiliated practices in their network. Not happening yet though the current administration is doing its best to push this technology by requiring all state designated entities that are standing up statewide HIEs to include Direct in the strategic operating plan.

10. Analytics & Business Intelligence Perceived as Nirvana 
Hit, kind of… 
In retrospect, not even sure this was really a prediction but simply more of a statement as to where healthcare organizations are headed with their HIT investments. We have a long ways to go, though there is certainly no lack of vendors that now are touting some form of analytics capabilities. Our advice, tread carefully as most solutions today are half-baked.

11) The Buzz at HIMSS’11? Everything ACO! 
Miss 
While some vendors were discussing ACO enablement at the 2011 HIMSS, the vast majority were not with the key focus continuing to be meeting Meaningful Use requirements. As mentioned in previous prediction, we see MU as a tactical issue with the strategic issue being: How do we leverage IT infrastructure to support communities of care? Maybe at HIMSS’12 we’ll see more discussion of this issue, but we’re not holding our breath.

This may have been our best year yet with our predictions having only 3 clear misses out of 11 predictions made. Granted, some of those predictions were not exactly the most profound or shall we say big stretches, but we do take some satisfaction in really nailing a few.

And while we intend to provide our own 2012 predictions, no time like the present to begin the process. So we ask you dear reader, what is your 2-3 top predictions for 2012? Will Todd Park stay on at HHS? Will forced budget cuts decimate HITECH? Will the Supreme Court’s ruling on ACA have any impact on HIT spend by either payers or providers? Will mHealth Apps such as WellDoc’s for diabetic care finally receive a CBT code thereby accelerating adoption of such tools?  We look forward to your input.

And of course we wish everyone a Joyous holiday season and wish you and yours continued good health in the new year to come.

Home for Christmas by Thomas Kinkade

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As part of the process of setting our broader research agenda at Chilmark Research, we do a significant amount of secondary research combined with more limited, but highly focused primary research. We use this research to identify the “white spaces” where there appears to be a demand for some thoughtful, in-depth research and reporting that only an analyst firm such as Chilmark can provide. During that process, however, we often uncover some interesting trends similar to the HIE Snippets of the previous post.

Chilmark continues to follow the patient engagement realm, from mHealth Apps to PHRs, patient portals and personal health platforms such as Dossia and HealthVault. Recently, we have been receiving a significant number of inquiries from healthcare organizations that are developing IT strategies to meet Stage 2 meaningful use criteria to provide patients online access to their personal health information (PHI). We are also beginning to hear very early rumblings by a few forward thinking organizations on the use of new technology platforms, particularly mobile, to more deeply engage patients in managing their health in conjunction with impending value-based contracts. There have also been several announcements lately of roll-outs of Epic’s mobile patient engagement platform My Health. Lastly, earlier this week we had the pleasure to attend GE Healthcare’s Centricity Business National User’s Conference where we sat in on several patient engagement presentations. Following are some of the trends we are seeing that will be foundational to our future research on the topic:

HIE Vendors not up to task: A number of large healthcare organizations that have grown organically and through acquisition have a multitude of legacy IT systems from numerous vendors (not everyone is going Epic) in place. These organizations are now looking to link these systems together with an HIE solution and while they are at it, want to be able to provide patient access to their PHI. Problem is, most leading HIE vendors that have proven solutions for interfacing to multiple systems typically have poor patient-centric solutions. There are exceptions to every rule and companies such as RelayHealth and Kryptiq offer quite capable patient portals combined with secure messaging. But for those HIE solutions that lack such capabilities, healthcare organizations are having to look elsewhere to fulfill this need which is bringing business to MEDSEEK and Intuit Health.

Patient Portals interface first to transactions: Several of the presentations at the Centricity event were given by organizations with distinct clinical and administrative systems. Maybe it was just the venue, it was a Centricity Business Users’ Conference after all, but in each presentation on patient engagement the patient portal was driven from the admin-side. Sure, the portal could provide labs and some basic clinical data but it was really designed to help with the pre-registration process, appointment scheduling, secure messaging and Rx refill requests. Each organization we spoke to have plans to bring clinicals (some had Epic for clinicals, others Cerner) into the portal in the future to facilitate care processes for the truly sick, but that is a second order priority. This raises the question: Will front-end admin solutions, like Centricity’s Business Suite, become the core patient portal at the expense of those developed and offered by those from the clinical side of the fence?

Still in very, very early stages of mHealth App adoption: As mentioned previously, a number of organizations (Group Health Collaborative, Kaiser-Permanente, Stanford, UPenn Medical Center, etc.) have announced the release of an mHealth App for patient engagement, virtually all of them, My Chart instances. These releases are basically a mirroring of what is being done with patient portals mentioned above – enable transactional processes. We have yet to see anything, at any organization that has gone beyond pilot stage (e.g.WellDoc in Baltimore) in the deployment of a mHealth App to address a large at-risk population. This is puzzling for as we move to value-based contracts and accountable care, healthcare organizations will need to seriously rethink how they deliver health to chronic disease patients not just in the exam room, but at the patient’s home, in their car at work, wherever they may be to ensure compliance. mHealth can play a very effective role here but organizations’ reluctance to adopt is a chicken and egg scenario. There is not enough evidence to prove efficacy of mHealth Apps but if they don’t adopt, the evidence will not present itself. This will eventually break-thru, the question now is simply, when? And based on what we have seen in healthcare IT adoption to date, it could be a much longer wait than many VC firms and entrepreneurs currently have in their financial models.

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While we receive many comments on this site to various postings, we received one this week that really caught our attention for a three reasons:

1) The author, Dr. Louis Siegel, speaks with some authority having not only been a practicing physician for many years but also an innovator/entrepreneur with a patent to his name and is now working to improve diabetes care via IT.

2) He takes a hard nose look at the practice of care, the apathy of patients and the need for a more engaging dialog between patient and provider that can begin with a common, shared and complete record. This sounds quite similar to our own argument to throw out the now dated and artificial terms of EHR and PHR to settle on one term, the Collaborative Health Record or CHR. 

3) In several conversations this week with a number of organizations regarding Monday’s post, one common theme has emerged: A significant cultural change needs to occur within the medical community if we wish to truly engage the patient as a critical, hell the most critical, member of the care team. That cultural change needs to begin with information sharing, information equality and it needs to begin with the clinician encouraging the patient to become an informed and knowledgable patient. 

Therefore, having contacted and asked for permission, which was readily granted, Chilmark has taken Dr. Siegel’s comment and moved it to the more visible and prominent position, that of a guest post. Dr. Siegel puts forth the challenge that the culture of care delivery and the apathy of patients needs to change as only then will we see broader adoption and use of patient engagement tools that go beyond simplistic marketing and towards shared decision making and ultimately, better outcomes.

Dr. Siegel:
Let me say a few things from the perspective of a physician, and one who has lectured on encouraging people to invest time and intellect in their health.

First, there is what I call the ‘Wall of Apathy’. People, alas, recklessly, dangerously, and wrongly, entrust their physicians with their healthcare and health facts. The Wall is very steep.

The Wall is steep because doctors like it that way and work to keep it that way.

What patients don’t know won’t kill them (‘them’ are the doctors).

Medicine is a closed society and the fundamental principle that a person’s health truths (labs, opinions, reports, etc..) are first the property of the person and second the property of providers has been negated and refuted at every turn by the healthcare profession and healthcare industry. Remember medical errors is the fifth leading cause of death so the last thing a doctor wants is a patient nosing around.

Both of these, the Wall of Apathy and the Closed Society explain why the PHR does nothing more than ‘crack’ the health truths door open a little and still keeps the patient out of the loop. PHRs are only a token, they provide little of the facts a person needs to know if their care is adequate and conforming to standards of care.

The whole notion of a PHR is a ridiculous attempt to share the person’s whole medical record pie. That is why there is no traction.

Healthcare delivery is created to be provider-centric not patient-centric and as such the record of a person’s healthcare is created to be the same way.

Forget PHRs and get ‘crackin’ on opening up a person’s entire record on a shared platform that is both provider and patient accessible and readable.

Being able to email your doctor and seeing an image of your labs does nothing to inform you of the fact that your prostate hasn’t been checked in three years and your last PSA, though in the ‘normal’ reference range is double the last one and possibly worrisome. Coding that is not difficult.

People would be horrified if their quarterly investment report was only a phone call from their broker’s assistant saying ‘everything is fine, let’s check in three months’ (no report, no on-line viewing, no quarterly calls), but are quite content to receive a call from their doctor’s secretary saying ‘the results of your blood work are fine’, and leave it at that.

How do you know that report she looked at was yours? It isn’t always.

Finally, medical reports reporting (what your doctor gets from labs, pathologists, radiologists, specialists etc.) is chaotic, non-standardized, and riddled with critical information buried deep inside that never sees the light of day, or the doctors or the patient’s eyes. Trust me on this.

One pathology report a patient I consulted on showed me a copy of a report their doctor received that had a big box checked ‘NORMAL’ and in the smallest font a sentence that said ‘Our criteria for normal is four malignant cells. This patient had three.’ The doctor looked at the box and missed the fine print. The patient read it, however.

Forget the notion of personal health records and rid ourselves of the notion that only SOME of my medical records are mine and some are my doctors. ALL my medical records are both personal, and mine.

After that, let’s get our IT heads together to work organizing the craziness in medical record reporting and dismantle the coveting of medical records by doctors and institutions and write smart systems that match diagnoses to standards of care and analyzes those records for errors of omission, trends, etc.

We can start with chronic diseases, like diabetes and others for which standards of medical care exist.

Let’s have a shared-care concept of care that shines the light of day on each person’s health truths.

All patients have that right.

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PHRs are much like the tides, news about them ebbs and flows. Right now, with the relatively recent demise of Google Health, Dossia’s attempts at rebirth, and the significant inquiries we are receiving regarding meaningful use requirements to host a PHR (patient portal). But in and amongst all this Chilmark has heard on more than one occasion the following statement: “The problem with PHRs is that they are a technology in search of a market.”

This statement is simply wrong for the following reasons:

1) As we have said countless times before in previous posts, very few people are interested in a digital filing cabinet for their health records. Unfortunately, many PHRs in the market today are just that, digital filing cabinets. In this case it is not an issue of a technology in search of a market, it is just a bad product that really has no market.

2) Technology adoption does not occur for its own sake, it occurs when there is perceived value by the user that leads to adoption. PHRs, PHPs (personal health platforms), patient portals, etc., is certainly a technology, that when well-designed, and implemented can deliver significant value and subsequently see high adoption rates. Just look to Kaiser-Permanente’s instance of MyChart, where patient adoption is well over 40%. Up in the Pacific Northwest, the Group Health Collaborative (GHC) is seeing PHR adoption that is well over 50%. That’s a market!

While there is indeed a PHR market, the market is immature and likely to remain so for the foreseeable future. The market is unlikely to be found in stand-alone PHRs or PHPs where it is incumbent upon the end user to populate the system and establish the critical links with the broader healthcare system (borg) to drive those high-value transactions. Rather. the near-term market for PHRs will be with those systems that are tethered to a healthcare provider, be it an individual practice, a hospital or large IDN such as Kaiser or GHC that have the critical linkages for transactional processes such as appointment scheduling, Rx refill requests, email consults. etc.

Unfortunately, for those with complex conditions, who have a multitude of doctors and/or specialists, these patients will be burdened with having a multitude of PHRs (patient portals) to visit to view their records and when desired, invoke a transactional process. The dream of one complete longitudinal patient record will remain such, just a dream especially for those who are in greatest need of one such record, our sickest, most needy patients.

And one last point…
Why are organizations such as KP and GHC seeing such high rates of adoption while many other organizations do not? Quite simple really, these organizations have built these patient portals (PHR) and the tools they provide into the clinician workflow and actually have clinicians encourage patients to use the PHR. Most organizations we have spoken to have failed to grasp this critical point, and maybe they really do not care, they’re just checking off the meaningful use box of requirements that must be met.

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From Chilmark Research’s perspective, patient portals are by and large Much Ado About Nothing. Sure, plenty of healthcare organizations (HCO) talk about patient access, engagement, and satisfaction and how they wish to empower their patients. They point to their glossy patient portal and say look at this wonderful tool we are providing for our patients. But if one digs a little deeper one finds that most patient portals suffer from numerous ills including:

  • Providing a patient only limited access to their records. There are no clear and consistent policies in place today as to what a healthcare organization is obligated to provide a patient access to.
  • Do not support portability that allows the patient to export personal health information (PHI) to another site/repository that they can then control (e.g., Google Health, HealthVault or other PHR).
  • Do not allow for patient entered data nor the ability for a patient to annotate records.
  • Rarely support transactional processes such as online appointment scheduling, Rx refill requests, eVisits.
  • Are just about as user friendly as a clinician’s EHR.

The problem with patient portals is that they are not seen as an integral part of the care process. In fact, we would argue that the use of the terms PHR and EHR create an artificial division – let’s just call it a CHR (Collaborative Health Record) and be done with it. But alas, such is not the case. Ask your local HCO where funding for their patient portal comes from – 9 times out of 10 they’ll say the marketing budget. As we reported from this year’s HIMSS conference, sure there was talk of patient engagement via portals but the message was one pitched to the Chief Marketing Officer (CMO) and not the other CMO, the Chief Medical Officer.

Yes folks, today the patient portal has very little to do with the patient being an integral part of the care team. No, the patient portal is all about improving consumer/patient satisfaction scores and more tightly linking the consumer to a given HCO. Therefore, is it any wonder then that if a patient portal is not viewed as an integral part of the care process then physicians are unlikely to actively advocate its use leading to a market where consumer adoption and use of patient portals remains at a paltry 6% or so nationwide.

As with anything in life, there are no absolutes and in the case of patient portals there are some stellar examples of HCOs using a patient portal to actively engage their patients. The most publicized example is Kaiser-Permanente with adoption at roughly 35% of all patients served. Primary to K-P’s success is providing its members not only access to their PHI, but also the ability to perform a number of transactional processes, e.g., appointment scheduling, online consults, etc. Up in the Pacific Northwest, the Group Health Cooperative (GHC) has also been very proactive and reports patient adoption and use of their patient portal at over 60% (that’s an order of magnitude greater than the national average!). The May 2010 research paper that GHC published in Health Affairs is pretty clear on what has driven such high adoption: the patient portal is not about marketing, but forging tighter links between the patient and physician to improve the efficiency and effectiveness of care delivered.

Now both K-P and GHC are somewhat unique in the healthcare market for both are “vertically integrated” being both the insurer and the provider. They assume the full risk of managing their patient/member populations and thus will seek out solutions and concepts that will lower medical loss ratios (MLRs) and keep their members in less costly care settings. Therefore, it is to their benefit to actively engage members in managing their health and both of these organizations have found their patient portals to be a critical piece in the engagement puzzle. With pending changes in payment models moving from fee for service to bundled payments, HCOs of all sizes will need to adopt business strategies similar to KP and GHC, including deeper, more meaningful patient engagement.

Thus, it is with disbelief that some of the recent comments to proposed Stage 2 Meaningful Use requirements state that it is unreasonable to expect physicians to have 20% of their patients using a patient portal. Now, we do agree that it is silly to ask every physician practice in the country to provide a patient portal, but it is not unreasonable for large physician practices, hospitals and clinics to provide such. Unfortunately, it appears that the medical establishment does not see the writing on the wall; that their future success is not contingent upon another marketing initiative but in truly and thoughtfully engaging the patient as part of the care team for if they were to do so, as KP and GHC have demonstrated, achieving that 20% target is not beyond reach.

Is your HCO rising to the challenge?

 

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The long awaited, dare I say anticipated HIE Market Report is now complete and ready for purchase. This report, arguably the most comprehensive report yet published on this rapidly evolving market (116pgs, 21 vendors profiled, 0ver 25 tables and figures) will provide the reader with a detailed portrait of today’s HIE Market, its leading vendors, and the capabilities that they bring to market. Here’s the HIE Report’s Table of Contents (warning PDF).

The report is the culmination of interviews with countless HIE stakeholders, from State and regional officials, to healthcare CIOs, consultants and of course the HIE vendors as well. Combining these interviews with our own methodology for secondary research, the report comes presents a number of findings including:

  • A definitive classification schema of current HIE vendors that will clarify what appears at first glance as a very convoluted market.
  • The transition that is occurring as vendors move from SaaS to PaaS models and its future impact on the market.
  • The clear differences and similarity of needs of Enterprise and Public HIEs.
  • An HIE Maturity Model that will help adopters of this technology better understand the transitions that will be needed as their platform matures over time.
  • Comprehensive profiles on 21 leading HIE vendors including rankings on a number of HIE attributes as well as market presence.

If you are involved in any aspect of the HIE market, you would do your company a favor by purchasing this report. Really, it is that good.

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