Chuck Christian, VP of Technology and Engagement, IHIE, Chapter 2

If there’s one word that could best describe Chuck Christian, it’s curious. Throughout his career — from the early days as an X-ray technician to more than 20 years as a health system CIO to now — he is constantly asking questions and trying to find ways to get the industry to a better place. It’s that drive that led him to his current role, where he is helping to lead one of the largest HIEs in the nation in its mission to leverage technology to improve patient care. In this interview, he talks about his passion for understanding policy and translating it to CIOs, his candid take on FHIR and how he believes it can work, how the Indiana HIE has been able to thrive (and what other HIEs can learn from its success), why clinical interoperability is so difficult, and why he believes the industry is just hitting its stride.

Chapter 1

Chapter 2



* Health Affairs study

* “There’s not just one flavor of health information exchange.”

* HIE as a noun vs verb

* Patient-centered data homes

* A one-stop shop for data: “That’s the functionality we have.”

* Problem with CCDs — “Physicians don’t want to have to weed through data.”

* Thoughts on MU/HITECH



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Bold Statements

There weren’t a lot of people out in the industry that knew how to do health information exchange. It’s not an easy thing to do, and a lot of people were saying, ‘we can do this. We can stand this up,’ and they’d burn through the cash.

There are many different flavors of health information exchange. There are many, like the one I work for, where we persist data and we normalize the data and it can be displayed side by side. It’s coded and it’s a really good clinical tool. But then you have those exchanges that are basically just moving transactional data around. They don’t really persist data.

If you look at some of the definitions that ONC and CMS use, they’re very EHR-centric, and there are thoughts out there that the data can be shared seamlessly from one EHR to the other. I have a lot of questions about how that happens.

If you talk to the clinicians, to the physicians, they don’t want a basket of data that they have to weed through and hunt for the nuggets. They want succinct information presented to them that’s based upon what happened to the patient and what the care plan is.

I think it’s kind of hamstrung part of the industry related to innovation, because we had to work so hard to meet those standards, and then rather than us setting those standards as the floor or the threshold, that’s became the ceiling.

Gamble:  There was a recent study from the Health Affairs that said the number of HIEs has dropped. What are some of your thoughts on why that’s happening and what HIEs need to do to survive?

Christian:  You have to go back and remember that a lot of this thing called health information exchange was mandated out of the HITECH Act because we need to share data and so we need some way to do. Oh, and by the way, we’re going to drop billions of dollars into the states with the HIE State Cooperative Agreement Program grants to stand these things up. Well, they’re not easy to do. And a lot states were going about it as a way to help create some modernization of their organizations internally. There weren’t a lot of people out in the industry that knew how to do health information exchange. It’s not an easy thing to do, and a lot of people were saying, ‘we can do this. We can stand this up,’ and they’d burn through the cash. After the grant money was gone, they hadn’t thought about how are we going to sustain this from a value proposition, so some of them failed.