41AMGA.ORG JANUAR Y 2019
The United States spends more on health care than any other country in the world, yet its ability to improve health outcomes lags that of other advanced nations in areas such as diabetes, respiratory disease, and
heart disease (see Figure 1). 1 Healthcare providers can
effectively improve outcomes and reduce care costs through
collaborative data sharing, with the ability to access data
from multiple providers at the point of care.
Community health information exchanges (HIEs) give
providers a critical line of sight into patients’ care needs and
concerns—insights that are especially valuable for patients
with complex needs and others who are high utilizers. When
the electronic health record (EHR) is complemented with
access to a community HIE, the data present a complete
narrative of the patient’s health history. It’s an approach that
improves continuity of care and increases value.
At Holston Medical Group (HMG), a regional medical group
that serves 200,000 patients in northeast Tennessee and
southwest Virginia, we began participating in the only fully
functioning, bi-directional, common medical record system
in Tennessee in 2012. Since then, our multispecialty medical
group has been a leader in encouraging other providers in
eastern Tennessee and southwest Virginia to join the community HIE. Today, 1,200 physicians are connected through the
For HMG, access to this data provides a comprehensive
picture of our patients’ health history and positions us for
success under value-based contracts through improved population health (see “HIE Successes at HMG”).
HMG’s experience points to five community HIE data access
paths to improved population health.
Five community health information exchange paths to improved
By Wesley Combs
U.S. OECD average
Infant mortality per
1,000 live births
Deaths per 100,000 population
Source: Organization for Economic Cooperation and Development (OECD).
Note: Average of 15 OECD nations with the largest per capita GDP for which data were
available in all years.