Table 1.

Overview of the Case Study Sites

Community	Bangor	Central Indiana	Greater Cincinnati	Inland Northwest	Keystone	Greater Tulsa	Western New York
HIE Name	HealthInfoNet	Indiana HIE (Indiana Network for Patient Care)	HealthBridge	INHS Health Information Network	Keystone HIE	MyHealth Access Network	HEALTHeLINK
Formed*	2004 / 2006	1995 / 2004	1997	1994	2005	2009	2001 / 2006
Service Area	State of Maine	Statewide and inter-state	16-county area of Ohio, Indiana, and Kentucky	14-county area of eastern Washington and western Idaho	31 counties in Central/Northeastern Pennsylvania	11 counties in Northeastern Oklahoma	8-county region surrounding Buffalo
HIE population**	1.2 million patients	2.7 million patients	>3 million patients	1.3 million patients	600,000 patients	>2 million patients	1.5 million patients
Key Stakeholders	4 health systems, payer, public health	Providers, public health, business groups	5 health systems and 2 health plans	Members of Inland Northwest Health Services, an independent entity	Geisinger Health System and 36 community provider organizations	Providers, payers, purchasers, public health, tribes, university, patients	Providers, payers, public health, educational and community partners
HIE Users (at time of study)	28 (of 39) Maine hospitals, 7,000 providers, 5 FQHCs	90 hospitals and 19,000 physicians	7,500 physicians and over 50 total hospitals	16 hospitals, 16 clinics, specialists, LTPAC providers	1,110 clinicians, 274 LTPAC users, 1,200 patients	1,600 providers	2,550 providers and 7,567 total users
Technical Architecture	Centralized	Hybrid-Federated	Hybrid-Federated	Centralized	Hybrid-Federated	Centralized	Hybrid-Federated
Patient Consent	Opt-out (opt-in for mental health)	Opt-out	Opt-out	Opt-out	Opt-in at each care site for full record	Opt-out	Opt-in
Selected Examples of Advanced Health IT Tools & Services (see Appendix for details)	Community wide disease registry Quality reporting and provider comparison Quality reporting and provider comparison Patient text messaging (pilot) Public health surveillance	Public health surveillance Health screening reminders Disease registry Quality reporting and provider comparison	Community-wide disease registry Predictive risk modeling Provider reporting dashboard; Patient text messaging (pilot)	Risk-based algorithm to refer diabetes patients Quality reports (sent to providers quarterly) Clinical decision support	KeyHIE Transform translates LTPAC patient assessment data to CCD format Electronic flu shot reminder Performance reporting	e-Referral management Predictive risk modeling Clinical decision support Analytics & reporting Cloud-based apps	EHR-based registries Clinical decision support Quality and outcomes reporting Telemonitoring Public health surveillance

Source: Authors’ analysis. FQHC = federally qualified health center; HIE = health information exchange; IT = information technology; LTPAC = long-term and postacute care.

Notes:

^*Date Formed: Where two dates are indicated, the first marks when foundational elements of an HIE began, and the second marks the official formation of the HIE organization.

^**HIE Population: The number of patients whose clinical data had been electronically exchanged and/or stored in some form through the HIE infrastructure at the time of the study.