ACOs: A sustainable business model for HIEs?

Few regional and state health information exchanges have found a sustainable business model. John Tempesco, chief marketing officer at ICA, a Nashville-based HIE vendor, recently told attendees at a Massachusetts conference that accountable care organizations (ACO) might provide the solution.

Speaking at a meeting of the Massachusetts Health Data Consortium, Tempesco said that the key to HIE success will be "patient centered HIE technology" that enables true communication at critical hand offs, collaboration across the continuum of care and analytics to determine best practices to reduce costs while improving quality. These also are the goals that ACOs will have to achieve.

Noting that the industry is moving toward a quality-driven model that depends on care coordination, Tempesco said, "The missing link to care coordination through automation has been a combination of both data portability and patient centric approaches to exchanging information in the healthcare sector. HIE provides the portability of patient records and the ability to put the patient at the center of the healthcare process."

What Tempesco didn't mention is that private HIEs within healthcare systems are growing much faster than public HIEs funded by state and federal grants. These private exchanges have forced the closure of some regional or community HIEs because of lack of support from the healthcare providers that have their own HIEs. Some observers expect that hospital-based ACOs will use private HIEs to exchange data across care settings.

Interestingly, ICA, which uses technology developed at Vanderbilt University Medical Center, serves both private and public HIEs. Among its clients are Vanguard Health System in Massachusetts, the Kansas Health Information Network, MidSouth eHealth Alliance, and Middle Tennessee eHealth Connect.