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.

HealthBridge, one of our partners in providing syndromic surveillance for the Ohio Department of Health, recently unveiled a new service that will alert physicians when one of their patients have an emergency room visit or admission to the hospital.

The system, ED Admit Alert, is a participant in the federal government Beacon Community Program—working as a model for information technology adoption. The ED Admit Alert system operates in real time, immediately notifying a physician when a visit or admission happens.

HMS recognizes the value of ED Admit Alert, particularly its close relationship to the function of syndromic surveillance. We believe that this function would add value to syndromic surveillance systems when ambulatory care patients and in-patients are added to emergency department surveillance.

One of the challenges to public health—when it comes to recruiting hospitals to participate in a syndromic surveillance system—is demonstrating value back to healthcare providers. ED Admit Alert’s notifications are an excellent example of how data can be meaningfully used to providers’ benefit.

Additionally, increasing oversight of readmissions and the advent of Accountable Care Organizations (ACO) have forced providers to look at their data much more carefully. Utilizing a system such as ED Admit Alert, in conjunction with a syndromic surveillance system, will provide more comprehensive data analysis capabilities. Operating in real-time, a surveillance and notification combination could immediately process and alert constituencies to events of interest.

ED Admit Alert and the information that it will provide to primary care practices will benefit patients, public health, and physicians themselves. It’s a positive step toward more effective public health maintenance and oversight.