Senators Question Failed HIEs
By Megan Williams, contributing writer
The Office of the National Coordinator for Health IT (ONC) is facing criticism of its programs from three senators who have been active critics of the programs in the past.
According to Politico, Sens. Lamar Alexander (R-TN), Richard Burr (R-NC), and Mike Enzi (R-WY) are questioning how officials used $600 million in grants to establish now-failing health information exchanges (HIEs). All three are members of the Health, Education, Labor, and Pensions Committee, (HELP) and have asked the GAO to review the HIEs.
As of January 9, a spokeswoman for the GAO said the review had just gotten started.
Alexander, Burr, and Enzi are not new to criticism of the EHR incentive program. In 2013, they wrote to federal health officials asking that the program be overhauled, earning themselves the nickname “reboot senators.” Several days ago, Alexander took control of the HELP Committee.
The HIEs, authorized by the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, have been met with skepticism from Congress along with the included EHR incentives and programs. This included the ONC’s $564 million grant to help states launch the exchanges. That money has now been spent, and some members of Congress are asking to know how exactly it was used.
HIE Results
The results of the HIE efforts have been mixed.
They have been found to provide clinical benefits like reducing the needs for imaging tests. At the same time though, the results are unclear.
As Business Solutions reported in December, “The RAND Corporation (supported by a grant from the U.S. Department Of Veterans Affairs) examined selected databases between January 2003 and May 2014. The study revealed that among the existing 100 HIEs, only 13 have been reviewed, with six of those being in New York State. It also found that while there is some evidence that they reduce utilization and costs in the emergency department, effects and other outcomes are uncertain.”
Beyond actual results, use of the exchanges is still low, according to Fierce EMR — only 2 to10 percent of patient encounters involve HIEs and that use was inconsistent. The researchers recommend that HIEs be looked at as “experiments” until more in-depth information is gathered. Fierce EMR quotes the study: “When considering the large public investments in HIE and its postulated critical importance to healthcare delivery, more studies are needed to identify what does and does not work and in what contexts. Until better evidence is available, all HIEs should be viewed as experiments and evaluated as such.”
Going Deeper
To read more about hospitals and their use of HIEs, read this article on the low implementation rates of facilities.