Direct Project vs. HIEs: Maximizing the Value of a Healthcare Dollar

Conceptually, most agree that HIEs (Health Information Exchanges) provide a means to improve healthcare delivery—especially on a regional basis.

So why would Tennessee decide to abandon its plans for a statewide HIE?

This question leads to other questions regarding HIEs, some of which we discussed in our past blog on HIEs: Do too many rights make a wrong?. First, how would an HIE fare in a cost/benefit analysis? Would it show a benefit in line with the time and money necessary to implement and maintain it?

And next, given the limited amount of money to fund HIEs, are there other initiatives that would show a greater return on investment from a healthcare standpoint?

Clearly for Tennessee the answers are “No” and “Yes.” As a result, the state has shifted its focus and resources toward ONC’s Direct Project—which promotes standards and protocols for the sending of secure and encrypted email messages, containing patient information, between healthcare providers.

The Direct Project is a low-cost solution that has shown quick, positive results. It helps hospitals and eligible professionals to meet Meaningful Use requirements. And it appeals to physicians and medical offices that do not yet utilize electronic health records. These professionals and offices stand to benefit from sending and receiving patient information via email.

While significant amounts of (primarily Federal) money has continued to flow into the development of HIEs, Tennessee’s decision presents an interesting contrast and will hopefully lead to a broader discussion on maximizing the value of each dollar spent on healthcare initiatives.