Axolotl Corp., Epic Systems Corp. and Medicity Inc. have the largest market shares of live, "validated" health information exchanges, according to a new report from KLAS Enterprises, a vendor research firm.

In its first look at HIE technology, Orem, Utah-based KLAS validated 89 live HIEs using commercial applications to exchange data. KLAS defines validation as meaning these HIEs are using the technology to share patient data that is being viewed by doctors, and exchanging data among facilities that are not owned by the same organization.

In a report last July based on annual surveys, industry advocacy group eHealth Initiative reported 57 health information exchanges being operational, with the vast majority of 150 surveyed HIEs having yet to begin operations.

Based on KLAS' research, Axolotl has seven live HIEs in the acute-to-acute market where two or more hospitals or health systems are exchanging patient information. Epic also has seven validated acute-to-acute sites, but its connectivity application connects only Epic software customers.

Medicity has 22 validated HIE sites in the acute-to-ambulatory arena, with at least one hospital or health system sharing data with a clinic, laboratory or other ambulatory facility, according to KLAS. McKesson Corp.'s Relay Health division has eight validated sites in this market.

The new report, "Health Information Exchanges: The Reality of HIE Adoption," highlights the commercial HIE technology of 22 vendors, most of which have one to three validated sites. Those with the most sites offer the least complex approaches to HIE, says Jason Hess, general manager of clinical research at KLAS and report author.

Surveyed providers reported several administrative challenges encountered as they deployed an HIE. Topping the list were I.T. governance regarding privacy, security and patient consent; and financial viability and sustainability of the HIE. More than 70 percent of the validated HIEs are funded with state or federal grants.
The report is available at The cost is $980 for providers and $10,850 for nonproviders.

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