Objective: To estimate costs and benefits for Australia
of implementing health information exchange
interoperability among health care providers and
other health care stakeholders.
Design: A cost?benefit model considering four levels
of interoperability (Level 1, paper based; Level 2,
machine transportable; Level 3, machine readable;
and Level 4, machine interpretable) was developed
for Government-funded health services, then validated
by expert review.
Results: Roll-out costs for Level 3 and Level 4
interoperability were projected to be $21.5 billion and
$14.2 billion, respectively, and steady-state costs,
$1470 million and $933 million per annum, respectively.
Level 3 interoperability would achieve steadystate
savings of $1820 million, and Level 4 interoperability,
$2990 million, comprising transactions of:
laboratory $1180 million (39%); other providers, $893
million (30%); imaging centre, $680 million (23%);
pharmacy, $213 million (7%) and public health, $27
million (1%). Net steady-state Level 4 benefits are
projected to be $2050 million: $1710 million more
than Level 3 benefits of $348 million, reflecting
reduced interface costs for Level 4 interoperability
due to standardisation of the semantic content of
Level 4 messages.
Conclusions: Benefits to both providers and society
will accrue from the implementation of interoperability.
Standards are needed for the semantic content of
clinical messages, in addition to message exchange
standards, for the full benefits of interoperability to be
realised. An Australian Government policy position
supporting such standards is recommended.
Bridging Organizational Divides in Health Care: An Ecological View of Health Information Exchange
