The trust factor: HIEs' progress in building meaningful relationships

Between the National eHealth Collaborative (NeHC)’s new report, “Health Information Exchange Roadmap: The Landscape and a Path Forward” and the IDC Health Insights new report, “Best Practices: Establishing Sustainable Health Information Exchange,” it’s hard to ignore an interesting, though not all that surprising, theme in the business of health information exchange: Building trust is key.

Of course, trust is an important component of every successful business endeavor or partnership but the HIE space uniquely has some pretty major barriers when it comes to forming relationships, and most of them can be drilled down to that charming five letter word. Let’s take some examples right from the reports’ findings.

According to a Healthcare IT News summary of the IDC report, resolving privacy and security issues will likely take longer than resolving technology issues for HIEs. While our experience supports this claim for many reasons, it is still worth pausing for consideration. Healthcare providers have a major responsibility to their patients to establish trust. These days, there’s nothing more sensitive or personal than an individual’s health, and receiving medical care means divulging it all to the provider.

But take that one step further. Now with the concept of health information exchange, a patient not only has to trust that his or her provider will handle that private information with the utmost security, but also that it will be securely and electronically shared only with the appropriate providers who may be caring for that patient in another environment -- with a specialist, in the event of an emergency, etc.

That’s where the security and privacy agreements come into play. There is no nonchalant “etc.” built into any contract. On the contrary, those instances of acceptable electronic data sharing and privacy are laid out in great detail in each individual’s contract with an HIE. These agreements will take many forms and go through many changes in order to meet the expectation of the provider and, most of all, the patient. So while the technology may be time-consuming and complex in its own right, accomplishing the strongest and best privacy and security agreement is a delicate balance that should never be rushed.

Similarly, the NeHC report identifies four major phases to establish a successful HIE and goes on to state, “Building trust among stakeholders and reaching agreement on the community’s guiding principles, goals and priorities for HIE is the most important outcome of [Phase 1].”  Without these trust relationships in place, the HIE will not have the foundation it needs to succeed.

When aligning these two findings, it seems clear that building trust will be not only essential to HIE success but also a major undertaking.  Those of us in the business already know this to be true. The very nature of an HIE means it is inherently the “middleman” when it comes to data sharing, and for that reason, the HIE must build a relationship rooted in trust with each of the participating data contributors and patient communities. It’s also important to keep in mind that the HIE business is still relatively new, and the concept, while noble, is still years away from being nailed down to an absolute science with clear methodologies.

In the meantime, we’re putting security at the top of our priority list. And it’s nice to hear that that’s the demonstrated path to success.

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