The United States had the largest market for health information exchange (HIE) in the world in 2013. Stimulus dollars allocated toward the advancement of the US healthcare system through the HITECH Act and the governments meaningful use initiative have aided the development of the HIE market in the United States. However, the adoption rate of HIE in the United States continues to lag behind countries in Scandinavia and Oceania.
Approximately $2 billion dollars have been set aside in order to develop the HIE infrastructure in the United States since 2009 and more than half of the money has been spent on HIE projects so far. The development of the healthcare IT infrastructure in the United States has not been uniform across different states and regions, and the costs of building and expanding HIE networks has become much more expensive when compared with other countries. Much of the funding is being devoted to electronic health records (EHR) in the United States because EHR infrastructure must be established before an HIE network is built.
The funding allocated for HIE development by the government is finite and there have not been any announcements of additional funds for HIE beyond 2018. Although the global market is expected to exceed $1 billion by 2018, the global market could contract as a result of reduced funding from the US government. Privately governed HIEs are also likely to represent a higher proportion of the market for HIE if public funding for HIE in the United States does not remain at elevated levels. An increase in private HIEs could actually reduce the adoption rate of the most mature HIE networks because private HIEs tend to use analytics more for driving efficiencies in patient treatment and hospital management rather than population health management.