Healthcare Executive - September/October 2013 - 14

we recognized early on, but we weren’t actively dealing
with 10 years ago,” says Thielst. “In 2013, people are now
focusing on the importance of making clinical information available to physicians, patients and their families.”

“We all need to accept that the only
thing we should be competing on is
performance. It’s not in anyone’s
best interest to compete on data.”
— Steve Robertson, FACHE
Hawaii Pacific Health

Share the Data, Don’t Compete on Data
Though more hospitals are participating in HIEs and
benefiting from this technology, many organizations are
still hesitant to make the leap beyond their core EHR system to one in which their patient data will be shared with
their competitors.
Christina Beach Thielst, FACHE, vice president, Tower
Strategies, Santa Barbara, Calif., has nearly 10 years of experience with HIEs, having helped establish the organizational
and governance structure of a regional health information
organization in Santa Barbara in 2004–2005. The purpose
of the organization was for countywide health information
exchange. But one of the most challenging aspects of this
project was convincing competing providers to share patient
information. The RHIo failed after several years of planning,
implementation and testing; but before it was fully functional.
“Playing nice in the sandbox was difficult for some of the
regional providers,” says Thielst.
Fast forward to today and HIEs are much more than just
sharing data between hospitals and payors—they are also
about making that information available to patients and
their caregivers. “That’s an important piece of this process

Healthcare Executive
SEPT/oCT 2013

Hawaii Pacific Health in Honolulu is the largest healthcare provider in the state, with $1 billion in revenue per
year. It uses the Hawaii Health Information Exchange,
and to participate in an HIE requires exchanging information with competitors, according to Steve Robertson,
FACHE, executive vice president and CIo, Hawaii
Pacific Health. “Sitting around the HIE table, you will
have competitors,” he says. “It may or may not be in your
best financial interest to use an HIE if you lose strategic
advantage, but everyone should be compelled to do the
right thing by the community in improving clinical care.
HIEs provide a standard of care that we must embrace.
“We all need to accept that the only thing we should
be competing on is performance,” says Robertson. “It’s
not in anyone’s best interest to compete on data. We
need to be transparent and, ultimately I would argue,
we shouldn’t compete on technology either if that
technology is improving clinical care.”
Nearly 400 healthcare providers, which include physicians, pharmacies, labs and other medical professionals,
use HHIE, and Hawaii Pacific Health exchanges patient
data with many of them. Most of the state’s 30 hospitals
have signed a letter of support for the exchange, but data
sharing agreements are still being refined, so few have
actually started sharing their information. To date, there
are only two agreements, but this will change quickly
over the next few months, according to Robertson.
IU Health shares patient clinical data with all 80 of
Indiana’s hospitals using the state’s IHIE. Goble believes
IHIE’s success is due to Indiana’s hospitals’ willingness
to collaborate and share data. “We are far ahead of
many other states in that area,” he says. IHIE was
launched in 2004 to help lower Indiana’s healthcare
expenses and improve the state’s rankings in leading
health indicators, including obesity, smoking, diabetes
and heart disease. IHIE partners with the Regenstrief

Healthcare Executive - September/October 2013

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