With their lofty promise of enabling hospitals, doctors and other community providers to share clinical information electronically, health information exchanges have garnered plenty of buzz recently as an essential component of care coordination and accountable care. But will HIEs, which the federal government has supported via incentives contained in the 2009 American Reinvestment and Recovery Act, succeed where previous, similar concepts like regional health information exchanges and community health information networks failed?

A new survey from the health care consulting firm Beacon Partners finds that while hospitals are enthusiastic about HIEs, few are actively planning or budgeting for participation. In addition, the responsibility for developing HIEs rarely goes above the chief information officer.

Roughly half of the survey's more 200 respondents — 58 percent of which represented community hospitals — said their hospitals have not created a department, oversight group or executive role to handle HIE development. When asked about their top concern, 41 percent of respondents identified high start-up costs or insufficient capital to support HIEs.

The survey also found that at 64 percent of hospitals, CIOs were the executive chiefly responsible for HIE development, a development that concerns Kevin Burchhill, a director for Beacon Partners.

"The CIO doesn't have the power of the pen," Burchhill told me recently. "They don't have the budgetary commitment or the organizational authority to set aside time. They're a little further down decision-making tree."

Burchhill is also concerned that the lack of appropriate financial resources for HIEs could spell doom for hospitals in a few years, when money from ARRA or other outside entities, like states or private foundations, runs out.

"The money to get started is coming from somebody else," Burchhill says. An HIE might get, say, $1 million from a foundation or a grant as seed money, he noted, but "when the money runs out, member organizations have to look among themselves and ask, 'how are we going to be sustained?' "

Burchhill recommends that hospitals bring together CEOs, the finance department and even physician leadership on a multidisciplinary team, ensuring that HIE initiatives have the proper strategic, financial and clinical input to thrive.

"I don't think anybody disagrees that HIEs are going to be part of the IT landscape and environment for years to come," Burchhill says. "The question is, how do you get started?"

Will HIEs succeed where other attempts at information sharing have failed? Email me at hbush@healthforum.com.