Running a Successful HIE Without Relying on Government Financing

Tennessee Health Information Exchange (TnHIE), one of the longest-operating health information exchanges (HIEs) in the United States, uses InterSystems solutions to power its self-sustaining network. The solutions help TnHIE overcome data integration and interoperability challenges, accelerate time-to-market, and ensure high performance, scalability, and availability for a host of advanced data aggregation, delivery, and reporting services. TnHIE helps healthcare organisations improve continuity of care and patient outcomes by providing fast, reliable, and secure access to over 1.5 billion clinical records.

TnHIE was established in 2005 to support the data exchange needs of the Tennessee’s healthcare community and launched full data exchange capability in 2012. Today, the non-profit organisation connects over 500 locations across Tennessee, serving more than 120 participants ranging from hospital systems and healthcare plans to EMS agencies, coroners, and rural pharmacies.

In Tennessee, state financing for HIE initiatives has been limited. Most of the regional exchanges that relied on government funding were unable to survive long-term. TnHIE took a vastly different path. From the outset, the exchange was conceived to be financially self-sustaining with minimal public funding, which is no small feat. To succeed, TnHIE needed a technology platform that could minimise healthcare data integration cost and complexity, scale flexibly, and support a range of use cases.

TnHIE switched to InterSystems technology in 2018 to bolster its foundational data exchange services. Today, the HIE leverages a variety of InterSystems solutions including InterSystems IRIS for Health™, HealthShare Unified Care Record and HealthShare Clinical Viewer, and InterSystems EMPI, to connect diverse systems, unify fragmented data, resolve duplicate and inconsistent identity records, and provide a uniform, uniquely identified community-wide record for each individual. The InterSystems solutions help TnHIE streamline the introduction of new services, simplify participant onboarding, and optimise system performance, scalability, and economics.

“InterSystems gives us the flexibility to grow, adapt, and deliver real value—which is critical for any HIE, especially with TnHIE being financially self-sustaining,” explains Pam Matthews, CEO and Executive Director of TnHIE. “If you’re willing to invest in the technology and supporting resources, you’ll get a lot out of it. For example, by leveraging HealthShare Unified Care Record and Clinical Viewer we were able to integrate SDOH data directly into a patient’s medical record.”

InterSystems solutions enable an array of high-value data services including:

• Unified clinical viewer – provides a consolidated, easy-to-understand view of patient data spanning multiple providers and facilities, with diagnostic-quality radiology imaging
• Customisable ADT alerts – delivers real-time notifications of hospital admission, discharge, and transfer events
• Advanced analytics – surfaces insights into historical patterns and trends, helping healthcare organisations improve clinical, operational, and financial performance
• Public health reporting – enables seamless data sharing with the Tennessee Department of Health to support immunisation tracking, disease surveillance, and other initiatives

TnHIE has grown by leaps and bounds over the years without heavily depending on direct public funding for financial sustainability. Today, the HIE includes patients from every county in Tennessee, all 50 states, and international visitors thanks in part to the region’s booming tourism industry. The network now delivers over 15 million ADT alerts and over 1.1 million HIPAA-compliant clinical messages annually leveraging its 1.5 billion available records.

“Our services have become indispensable to our participants,” says Matthews. “In one case, a major provider experienced a week-long system outage and relied entirely on TnHIE’s Clinical Viewer to maintain continuity of care, without missing a beat.”

Building on its success, TnHIE is preparing for the next phase of growth and innovation. Future plans include enhancing analytics capabilities, further expanding the participant network across Tennessee, as well as deepening the existing partnerships such as with public health agencies. With InterSystems as its technology backbone, TnHIE is well-positioned to continue advancing its services while staying true to its community-first mission.