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The History of HIE Part II – Image Exchange’s Impact in New York State

March 10, 2021


eHealth Company

By: Gary Larson, Executive Vice President, General Manager, HIE Solutions and John Refeinberger, Director, Project Management/Customer Success, HIE Solutions

New York State Leads the Way

In The History of HIE, Part One – The Early Years, we shared some of the challenges of starting up a RHIO back in 1999. There were no grants, and no state or federal handouts available to fund HIEs—their existence was totally dependent on providing value. Little did we know that five years later New York State began funding programs to identify opportunities for technology investments that would improve the delivery of health services on a regional and state level.

In 2006, the New York State Department of Health announced grants totaling $53 million to support 26 projects including the startup of Regional Health Information Organizations (RHIOs). While a few of these original regional alliances have combined with other entities, all remain operational to this day. The formation of the New York RHIOs is what enticed me to partner with an HIE vendor in 2007 to deploy solutions with five of the newly formed entities.

As part of our ongoing history lesson, when the Office of the National Coordinator for Health Information Technology (ONC) announced in 2009 it would distribute $564 million to states and territories to enable health information exchange, in the spirit of entrepreneurship HIE vendors suddenly appeared overnight claiming they had the interoperable health information technology solution. Search engines, tele-coms, medical equipment companies, EHR vendors, and more all had solutions to sell. It’s no wonder why many of the new state initiatives failed. Several of these vendors could not deliver, and more importantly, did not have the governance, policy and procedure, and technical implementation strategy of New York’s approach for improving the quality and efficiency of care.

Adding Value with Image Exchange

eHealth Technologies, headquartered in Rochester, NY, recognized that one of the most vital missing HIE capabilities across the state was the ability to access medical imaging exams. Not only is medical imaging an absolutely vital tool for diagnosing and treating chronic and acute medical conditions, but it also represents about 10% of health care spending – that’s nearly $1,000 annually for every person in the USA! Our proximity to this hotbed of HIE activity, coupled with our inherent expertise in imaging (given that many of us had formerly worked at Kodak), presented us with a unique opportunity to build an image sharing service that not only performed beyond expectations, but was also more cost-effective than other approaches. Together with the Rochester RHIO we integrated our service with their HIE platform and launched our first connected imaging provider, FF Thompson Health, in early February 2009. We never looked back! Soon neighboring HIEs across central and western New York recognized the value of incorporating images and quickly followed suite.

Our vision of providing ubiquitous access to diagnostic quality medical images at the point of care was shared by the New York eHealth Collaborative (NYeC), which in 2016 launched an initiative to expand Image Exchange services across the regional HIEs that had been certified as Qualified Entities (QEs) by providing a standard set of baseline image exchange services. eHealth Technologies had the privilege of providing those services and, in turn, we were able to expand our footprint to the majority of major institutions across our existing HIE customers and grow our presence downstate with the New York City HIEs.

Today the state of New York is a shining example of how image sharing can be one of the highest value “sticky” services provided by health information exchanges. We are continuing to work with our HIE partners and their constituents to break new ground by launching new services such as Automated Imaging Workflow and FHIR for imaging. Our vision of improving the quality and efficiency of health care delivery is alive and well in our “home state” of New York!

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