HIEs: Is the Failure to Launch Due to Lack of HIT Interoperability or Purely Business Economics?

We’ve been hearing about HIEs for some time now.  What we haven’t heard much is any real success from it.  When I first started read about it back in 2008, it sounded like a no-brainer to me. And especially when it intersected with Meaningful Use and the move to EHRs?  A double-no brainer.  However, with the exception of isolated HIEs here and there, the concept hasn’t really gained much traction.  Why is that?  Most of the reasoning seemed to come from the lack of interoperability due to the lack of standardization of the myriad types of healthcare data—-claims, EHRs, lab, radiology, etc.  However, this article introduces another concept that maybe the real culprit in this failure to launch—it’s not a profitable business as of yet.

What are your thoughts?  Do you agree w/this Brookings Institute report or do you still believe that it lies squarely on the shoulders of interoperability issues?

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