- By Dale Emerson
Sustainability is the ultimate goal for any HIE. The success and sustainability of an HIE is built on three key factors:

- Developing trust between HIE stakeholders and using that trust to obtain important financial data and information.

- Creating realistic, believable, and supported financial models to obtain the buy-in from all stakeholders.

- Providing various tools to respond to changes in the environment and make real time modifications to the financial model.

In order to create a believable financial model, stakeholders need to provide data and information about their current and planned operations. In many instances, stakeholders may be competitors and therefore reluctant to share their data and information. Using a third party that is viewed as a trusted resource by all stakeholders is critical to obtaining the required data and information. In order to be believable, it must be sanitized using a process of obtaining the information, analyzing it, reporting it and discussing it, while maintaining the confidentially of the information for each stakeholder.

Once the financial model is built, there must be a mechanism for changing it as the environment changes. In addition, it must accommodate input in various forms from diverse stakeholders. “Dashboard” type applications and tools are relatively common in the private sector, and can be easily adapted for use in healthcare. They will allow decision makers to input data and information, change assumptions and strategies, and immediately see the impact on the underlying financial model.

In summary, it is critical to start with solid data and information. This can only be obtained if a certain level of trust exists with the stakeholders. Therefore, it is important to start the HIE process with an open and transparent process that builds trust from the beginning. When trust is developed, then reliable and believable financial information can be collected, analyzed and reported.