There are minimum standards that should be met by state of the art vendors. These key components serve as the foundation from which Health Information Exchange Vendors can be measured.
Sandlot’s industry experience and our observations of state-issued RFPs suggests that health information exchange (HIE) or health information technology (HIT) authorizing bodies might want to consider more precise and detailed requirements from vendors seeking to provide state services.
To ensure that HIE bid evaluators and stakeholders can make a fully informed decision, successful applications should focus on the following provisions:
- Vendors should have experience running an operational HIE for at least two years.
- An operational HIE system should have critical mass. For example, an HIE should have the capability to connect multiple hospitals, labs, a pharmacy system, 300 or more physicians, 50,000 or more clinical transactions per month and contain 400,000 or more patient records.
- An operational HIE solution should have the capability to parse and move data between at least two non-related electronic medical record (EMR) systems and not just transmit scanned documents from several sources. The system must be able to sort out duplicates and incorporate all data into one comprehensive electronic health record (EHR). For example, if lab results come from two different labs the HIE should merge them into one EHR lab record. Or, if a diagnosis come from two EMRs, the HIE system should merge them into one diagnosis.
- HIE software should be interoperable. A true interoperable HIE means a vendor must show that it can connect and communicate to two or more non-owned or affiliated sources. It should not be a vendor silo – one integrated delivery system owned by the same entity.
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Operational HIE solutions should have the following portal capabilities:
- e-prescribing
- e-lab
- secure messaging
- referral management
- ability to input clinical data from portal
- clinical email alerts
- reporting modules
- An HIE should have an enterprise master patient index (EMPI) that can incorporate many sources, not just one or two match rates, and should be at the 98th - 99th percentile – not the 95th percentile. The EMPI helps to insure patient privacy and confidentiality through unique identifiers.
- HIE vendors must also show a proven track record for adoption success among physicians, hospitals and other healthcare providers. The vendor should be able to show that they built a system to which users easily adapted and demonstrated high usage rates.
- HIE vendors must show a high opt-in rate from patients — we believe 75 percent or more is a valid level.
- HIE vendors should be able to demonstrate that the system is sustainable and can continue to operate with non-grant related sources.
