Optimizing the benefits of hospitals in health information exchange networks: An integer programming model

Health information exchange (HIE) is the movement of healthcare data between healthcare entities. Joining HIE networks helps hospitals to avoid many unnecessary activities such as repeated visits due to the availability of information. However, joining a HIE network is not free because the hospitals must pay the HIE owner a membership fee. Various subscription plans are offered by the HIE owner; the hospital must choose one subscription plan at the point of joining the network. This research develops an integer programming model that maximizes the benefits of hospitals while ensuring that the network remains profitable for the HIE owner. Three subscription plans are considered: per visit, per look-up, and per service. In the per visit plan, the hospital pays the HIE owner for each patient visit. In the per look-up plan, the hospital pays only for a subset of the visits depending on the per look-up rate. In the per service plan, the hospital pays only for a subset of the visits depending on the percentage of avoided visits. The results of this research help decision-makers gain a broader understanding of the costs and benefits of HIE networks.