A recent article in HealthAffairs describes a significant decline in the number of both operational HIEs and HIEs in the planning stage from several years earlier. The authors note continuing barriers to broad-based HIE and a shift to vendor-driven exchange which diminishes the effectiveness of community-based networks. In effect, this translates to a shift away from geographic-based/dominated HIEs to product-dominated HIEs. We have already noted (see The Interoperability of Things) the lack of a national strategy on HIE, and ONC’s Nationwide Interoperability Roadmap barely mentions the concept.
In February 2022 the Sequoia Project released its Emergency Preparedness Information Workgroup’s Pandemic Response Insights and Recommendations. This workgroup was convened in the fall of 2020 at the height of the pandemic with a diverse set of stakeholders from all areas of the healthcare system. The resulting short report is worth a read as it offers concise analysis and recommendations. The first task the workgroup undertook was to conduct a SWOT (strengths, weaknesses, opportunities, threats) analysis focused on pandemic response. There was a strong public health focus that resulted from this activity: “During a declared emergency, and during non-emergency times as well, public health should be viewed as a collaborator and partner with equal access to shared data” (p. 6).