The U.S. Health Information Exchange Market

A Comprehensive Guide to Market Dynamics, Technology

Vendors, and Future Trends

November 2012

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Market Overview

• This study pertains to the following region:

United States

Over the period –

2012 to 2016

• Health information exchange (HIE) refers to the electronic

exchange of protected health information among multiple

stakeholders and participants including healthcare providers,

payers, public health organizations, state and local Health

Information Exchange Organizations, federal government

agencies, and patients.

• HIE is a key component of the U.S. government’s drive to

accelerate the use of health IT through the HITECH Act and

Meaningful Use program. The U.S. government has allocated

around $548 million in toward various HIE efforts at the state

level. HIE is also essential to ensuring goals around improved

quality, safety, access, and efficiency as stipulated by the

Patient Protection and Affordable Care Act (ACA) and is a core

competency for forming new delivery models like Accountable

Care Organizations (ACOs.)

• HIE entails many complexities related to privacy, security,

accuracy, authorization, interoperability among disparate

technical infrastructures, varying semantic standards, and other

issues. The market is highly dynamic with a plurality of IT

vendors providing services and solutions to both the private

(enterprise) and public HIE market segments. Source: Frost & Sullivan analysis

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Scope of Study

• This study provides a roadmap for understanding health information exchange, i.e. the process of health information

exchange (the verb), health information exchange organizations (the noun), and applications and services that

constitute health information exchange. We provide an in-depth overview of the technical aspects of health

information exchange; review major government initiatives driving health information exchange efforts across the

U.S.; define and describe the two major market segments, public and private, including technology solutions and

services used within each market segment and sub-segment; discuss the overall competitive market structure

including common business models and pricing approaches; and review key market considerations and strategic

imperatives relevant to a variety of stakeholders, including IT vendors and providers involved in this market. We also

provide brief profiles of 18 technology vendors serving the market.

• This study pertains only to health information exchange in the U.S.

• The study primarily focuses on two key market segments for health information exchange--public, referring to federal,

state, local and community health information exchange efforts and organizations and private, referring to health

information exchange that is created, sponsored, and governed by a single entity or enterprise such as a hospital or

integrated delivery network (IDN).

Products included in study

• While this study describes a range of technology applications and services that are contained within many health

information exchange platforms, such as master patient identifier, electronic health records, clinical decision support,

analytics, e-prescribing, and others, we do not specifically address the separate markets for each of these applications

and services.

• As health information exchange is primarily a process that entails myriad technology applications and services, we do not

size and forecast market revenues nor do we forecast market penetration due to the highly variable, dynamic, and

evolving nature and meaning of health information exchange.

Exclusions and Limitations

Source: Frost & Sullivan analysis

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Market Segmentation

Source: Frost & Sullivan analysis

Federal/

NationalState

Community/

LocalProvider/IDN

Public

• Designed to

connect federal

agencies

• Government

funding and

governance

• Connects with

State HIEs, RHIOs,

private HIE

• Encompasses

NwHIN

• Organized and

governed by states

• Start up funds

provided by

government grants

• Connects to RHIOs

and private HIE

• Multiple independent

entities in urban or

rural areas collectively

get together to share

information (e.g.,

RHIO)

• Created, sponsored,

and governed by a

single entity or

enterprise (e.g.,

hospital, IDN)

Private

Health Information Exchange Market Segments

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Enables coordination of patient care across disperse settings

Ensures cost savings from fewer redundant procedures and tests

Drives patient engagement and health awareness

Reduces unnecessary hospital admissisions due to closer coordination and monitoring

Improves the quality and safety of patient care

Empowers users with key knowledge for effective

decision making

Promotes operational and cost efficiencies and workflow

enhancements

Facilitates a uniform and multi-dimensional view of patient

and population data

Connects key data needed for clinical and syndromic surveillance

Creates a rich soure of data for clinical trials and outcomes research

HEALTH INFORMATION EXCHANGE

Potential Benefits and Advantages of Health Information

Exchange

Source: Frost & Sullivan analysis

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Source: eHealth Initiative, Thomson Reuters, and Frost & Sullivan

Va

lue

-Ad

de

d H

IE S

erv

ice

s

Medication Reconciliation

Certified Physician Order Entry

EHR-lite

ePrescribing

Care Coordination

Administrative Services

Patient Engagement

Quality Reporting

Co

re H

IE S

erv

ice

s

Master Patient Index

Master Provider Index

Record Locator Services

Clinical Messaging

Clinical Data Repository

Longitudinal Patient Record View

HIE to HIE Interoperability

HIE-Related Meaningful Use support

Core and Value-Added HIE Services

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1-2 Years 3 Years 4 Years

Growing Provider Consolidation

Increased Adoption of EHRs and Progressive Meaningful Use Requirements

Need to Improve Cost and Operational Efficiencies

Preparation for Accountable Care and Value-Based Purchasing

Key Market Drivers and Restraints

Impact: High Medium Low

Health Information Exchange Market: Key Drivers and Restraints, U.S., 2013-2016

Source: Frost & Sullivan analysis

Dri

vers

Re

str

ain

ts

Lack of Uniform Goals and Strategic Vision

Uncertainty and Confusion about Overall Market Direction

High Costs and Lack of ROI

Competing IT Priorities and Time Constraints

Fear of Losing Competitive Market Advantage

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Summary of Strategic Market Issues and Future Trends

Source: Frost & Sullivan analysis

2

3

4

5

1

The Drive for Greater Information Transparency Will Continue to Challenge

Privacy Concerns

The Move to Accountable Care Will Mostly Benefit Private HIEs in the Short

Term

The Growth of Cloud and Mobile HIE Will Accelerate Significantly

Innovation in Providing Value-Added HIE Services Will be the Key Competitive

Differentiator

Efforts to Ensure the Ongoing Viability of Public HIE Likely To Increase

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Contact

Britni MyersCorporate Communications

(210) 477-8481

britni.myers@frost.com

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The Frost & Sullivan Story

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Global Perspective40+ Offices Monitoring for Opportunities and Challenges

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